Obstructive sleep apnea and cardiovascular disease: Is mean platelet volume one of the links?

To the Editor,

We read with great interest the excellent review entitled “Obstructive sleep apnea and its effects on cardiovascular diseases: a narrative review” by Rivas et al. (1) on the cardiovascular comorbidities of patients with obstructive sleep apnea (OSA) published. Indeed, it is increasingly being appreciated that patients with OSA are at a higher risk of coronary artery disease, congestive heart failure, stroke, and atrial fibrillation. Treatment with continuous positive airway pressure (CPAP) reduces these comorbidities (1).

A novel important, though less widely used, marker of the severity of OSA is mean platelet volume (MPV), as shown by Varol et al. (2, 3) and us (4). Again, CPAP treatment has been reported to reduce MPV (3). Given its role as a marker of vascular disease and a predictor of acute vascular events (5), it appears that MPV also links OSA with cardiovascular disease. Specifically, in patients with OSA, MPV is also associated with atrial fibrillation (5).

In conclusion, it is now established that OSA poses patients at an increased risk of cardiovascular disease (1). MPV may prove useful as a marker of the latter in patients with OSA (4, 5); therefore, it should be more widely utilized for this purpose.