Background Congestive heart failure (CHF) is a major public health problem that is related to substantial morbidity, impaired quality of life and diminished survival. Mean platelet volume (MPV) is an indicator of platelet activation.

Aim To investigate whether there is a difference of MPV in patients with decompensated and stable heart failure (SHF), and test the prognostic value of MPV in decompensated heart failure (DHF).

Methods 136 consecutive patients with DHF were enrolled. 71 with SHF were also enrolled for comparison. Patients were followed up for a mean of 18±12 months. The primary endpoint was death from any cause. Clinical characteristics of patients with DHF who died during follow-up were compared with the those of the survivors.

Results MPV was significantly higher in DHF group than in the SHF group. 71 patients died during the follow-up period (18±12 months). Comparison with survivors revealed that mortality was associated with age, systolic blood pressure, pulmonary artery pressure, serum creatinine, urea and MPV. MPV was determined as an independent risk factor for mortality (OR 1.553, 95% CI 1.024 to 2.354, p=0.038). Receiver operating characteristic analysis showed that MPV level on admission was a predictor of mortality (area under the curve (AUC) for in-hospital mortality was 0.716 (95% CI 0.632 to 0.789, p=0.003) and AUC for 6-month mortality was 0.815 (95% CI 0.74 to 0.877, p<0.001), respectively).

Conclusion MPV is increased in patients with DHF. Also, MPV on admission is an independent predictor of in-hospital mortality and 6-month mortality.