Elevated MPV: A Key Indicator of Acute Anterior Circulation Stroke Prognosis in Mechanical Thrombectomy

Shi-Yuan Tian,1 Min-Jie Yu,2 Kefu Mei,1 Bing Xu,1 Lian-Chen Xiao,1 Hong-Bin Wen,1 Fu-Rong Shang1 1Department of Neurology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, People’s Republic of China; 2School of Medicine, Wuhan University of Science and Technology, Wuhan, Hubei, People’s Republic of ChinaCorrespondence: Fu-Rong Shang; Hong-Bin Wen, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, People’s Republic of China, Email [email protected]; [email protected]: The aim of this study is to investigate the relationship between admission platelet indices and 90-day clinical outcomes in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT).Methods: A retrospective analysis was conducted on 247 AIS patients with anterior circulation large vessel occlusion (LVO) treated with MT between July 2021 and April 2024. Platelet indices (PIs) were measured at admission. Participants were stratified into two groups based on 90-day modified Rankin Scale (mRS) outcomes. Multivariate regression analysis and receiver operating characteristic (ROC) curves were employed to evaluate relationships between admission platelet indices, clinical parameters, and functional outcomes.Results: Among 247 enrolled patients, those with unfavorable outcomes (mRS 3– 6) exhibited significantly higher platelet distribution width (PDW) and Mean Platelet Volume (MPV) levels compared to the favorable outcome group (mRS 0– 2). Elevated MPV remained an independent predictor of unfavorable outcomes after multivariate adjustment (OR=2.747, 95% CI: 1.791– 4.216, P< 0.001). ROC analysis identified a MPV threshold > 10.75 fL for predicting unfavorable prognosis, demonstrating 55.4% sensitivity and 81.2% specificity.Conclusion: PDW is associated with unfavorable 90-day outcomes in patients with acute anterior circulation LVO following MT, while elevated MPV may serve as a prognostic indicator for unfavorable functional outcomes in patients with acute anterior circulation LVO following MT.Keywords: mean platelet volume, mechanical thrombectomy, large vessel occlusion, stroke prognosis, platelet indices