Mean platelet volume combined red cell distribution width as biomarker of chronic obstructive pulmonary disease with pulmonary heart disease.

BACKGROUND AND OBJECTIVE Platelet activation, inflammatory reactions and oxidative stress are common pathogenesis of chronic obstructive pulmonary disease（COPD）with pulmonary heart disease (PHD). Mean platelet volume (MPV) and red blood cell distribution width (RDW) form part of the pathomechanisms of these conditions. Here, we investigated whether MPV and RDW can be biomarkers of PHD occurring secondary to COPD. METHODS This was a retrospective study on 229 participants with COPD. Among them, 69 had PHD.Complete blood count(CBC), blood gas analysis,pulmonary function tests and echocardiography were analyzed. RESULTS MPV and RDW-standard deviation(RDW-SD) were significantly higher in patientswith PHD than in patients withoutPHD(P ≤0.001). MPV and RDW-SD were positively correlated with pulmonary artery pressure (PAP) and the size of the right ventricle (P ≤0.05). Multivariate regression analysis showed that the risk of PHD increased threefold pera unit rise in MPV (OR =2.901, P≤0.001). We observed that the risk of PHD increased 1.5 times pera unit rise in RDW-SD (OR = 1.371, P≤0.001).The AUC of ROC curvefor the combined MPV and RDW-SD in predictingPHD among COPD patients was 0.900 (95％CI：0．846-0．954，P ≤0.001)，with a sensitivity of 76.8% and a specificity of 99.4%. CONCLUSIONS Both MPV and RDW-SD were significantly elevated and correlated with disease severity in COPD patients with PHD.A combination of these two parameters presents an effective biomarker of PHD.