Prognostic value of platelet volume indices in heart failure: a systematic review and meta-analysis.

Objectives: Heart failure (HF) is a complex condition with a substantial global prevalence and clinical burden. Prognostic biomarkers are essential for effective management. This study systematically reviews and synthesizes the prognostic value of mean platelet volume (MPV) and platelet distribution width (PDW) in HF patients.

Methods: A comprehensive search was conducted in Medline, Scopus, Web of Science, and Embase databases. Eligible studies were identified, screened, and selected according to pre-defined criteria. Data extraction and quality assessment were performed by independent reviewers. Meta-analyses were conducted using random-effects models, and heterogeneity was assessed using I² statistics. Publication bias was assessed using Egger's regression and Begg's tests.

Results: From 12471 records, 21 studies were included. MPV showed significant predictive value, with pooled hazard ratios (HR) of 1.49 (0.67-3.32) and odds ratios (OR) of 1.71 (1.5-1.91) for mortality and morbidity. The pooled mean difference in MPV values between the affected and unaffected subjects was 0.66 (0.21-1.1, P=0.008). MPV was positively correlated with NT-proBNP levels (pooled coefficient: 0.13, P=0.028). The pooled area under the curve for MPV in prognosticating adverse outcomes was 0.75 (0.69-0.82). However, PDW did not show significant prognostic value (HR: 1.56, OR: 1.11).

Conclusions: MPV is a useful prognostic marker in HF, associated with increased mortality and morbidity. Prognostic significance of PDW remains unclear, requiring additional research. The application of MPV can improve risk stratification and management of HF, but further research with larger populations and diverse settings is essential to confirm these findings and establish clinical reference ranges.