Prognostic Significance of Mean Platelet Volume in Acute Ischemic Stroke

Background: Platelet size indexes reflect platelet reactivity and thrombotic potential. Mean platelet volume (MPV) may relate to stroke severity and functional disability. This study assessed the association between MPV and Modified Rankin Scale (mRS) scores in acute ischemic stroke (AIS). Materials and Methods: In a prospective observational study at a tertiary-care hospital, adults (≥18 years) presenting within 48 h of AIS were enrolled. Exclusions were hemorrhagic stroke, known platelet disorders, hematological malignancy/procoagulant disease, prior thrombolysis or thrombocytopenia-inducing drugs, autoimmune/systemic malignancy/active infection, TIA, chronic kidney/liver disease, prior stroke, aphasia/dementia or reduced sensorium precluding consent, and symptom onset >48 h. Demographics, risk factors, and MPV were recorded; functional status was assessed by mRS at admission. One-way ANOVA tested MPV across mRS categories. Results: Sixty-nine AIS patients were included (mean age 53.99 ± 11.19 years; 71.01% male). Comorbidities included type 2 diabetes (21.74%) and hypertension (15.94%); 53.62% reported addictions (smoking and/or tobacco chewing). Overall mean MPV was 11.05 fL. mRS distribution at admission: 3 in 59.42% (n=41), 4 in 17.39% (n=12), and 5 in 23.19% (n=16). MPV rose stepwise with severity: mRS 3, 9.66 ± 0.89 fL; mRS 4, 11.98 ± 0.58 fL; mRS 5, 13.91 ± 0.83 fL (ANOVA p<0.05). Conclusion: Higher MPV at presentation is associated with greater functional disability by mRS in AIS. MPV may aid early risk stratification and triage in resource-constrained settings.

Keywords: Mean Platelet Volume; Acute Ischemic Stroke; Modified Rankin Scale; Prognosis; Disability.