Abstract Details

Title Mean Platelet Volume and Clinical Outcomes After Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P7 - Poster Session 7 (8:00 AM-9:00 AM)

Poster/Presentation
Number 4-022

Objective To summarize the current evidence on the association between mean platelet volume (MPV) and prognosis after aneurysmal subarachnoid hemorrhage (aSAH).

Background

Elevated MPV reflects systemic and cerebral platelet hyperactivity, potentially promoting microthrombosis, persistent vasospasm, and neuroinflammation, pathophysiological mechanisms that underly aSAH main complications like delayed cerebral ischemia (DCI). Nevertheless, the prognostic significance of MPV in aSAH remains unclear, and further evidence is required to better define its clinical relevance.

Design/Methods A systematic search of PubMed, Embase, Scopus, Web of Science, and Google Scholar up to September 2025 identified studies assessing MPV in aSAH. Random-effects meta-analyses and sensitivity analyses were conducted to assess the robustness of pooled estimates, with narrative synthesis applied when meta-analysis was not feasible. Study quality was evaluated using the Newcastle–Ottawa Scale, and evidence certainty was graded with GRADE.

Results 18 studies comprising a total of 5725 patients were included. MPV levels (fL) were significantly higher in patients with DCI than in those without (MD: 0.39; 7 studies; 2,488 participants; 95% CI: 0.07–0.72; I² = 94.1%), with very low certainty of evidence. Sensitivity analysis confirmed the robustness of this findings. Patients with poor functional outcomes (mRS 3–6) exhibited a nonsignificant tendency toward higher MPV levels compared with those with favorable outcomes (mRS 0–2) (MD: 0.57; 3 studies; 1,255 participants; 95% CI: −0.39 to 1.53; I² = 94.8%). A leave-one-out analysis produced similar results, supporting the stability of the findings, although the certainty of the evidence was rated as very low. 15 studies were assessed as having a low risk of bias and 3 as having a medium risk.

Conclusions The biomarker was significantly elevated in DCI compared with non-DCI, suggesting its potential prognostic utility and supporting its possible relevance. However, the future large-scale are warranted to validate its role as a reliable biomarker in DCI.

Authors/Disclosures
Ivan Alegre-Cordero PRESENTER	Mr. Alegre-Cordero has nothing to disclose.
Freddy F. Arcos Rivera	Mr. Arcos Rivera has nothing to disclose.
Alonso S. Solano Liñan, Jr.	Rev. Solano Liñan has nothing to disclose.
Gerardo M. Luna-Peralta	Mr. Luna-Peralta has nothing to disclose.
Angela Ariana Milagros Salvador Palma, Student	Miss Salvador Palma has nothing to disclose.
Yenko B. Damjanovic-Burga, Jr.	Ms. Damjanovic-Burga has nothing to disclose.
Miguel F. Cabanillas Lazo	Mr. Cabanillas Lazo has nothing to disclose.
Carlos Rodrigo Q. Vicuña	Mr. Vicuña has nothing to disclose.

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