Objective: To determine whether an association exists between mean platelet volume (MPV) and severity of acute ischemic stroke. Also, to investigate the power of MPV for discriminating more severe ischemic stroke from mild events.

Methods: We divided 100 patients with first ischemic stroke presenting to the Neurology Department, Fatemieh Hospital, Semnan, Iran between January 2010 and January 2011 into 2 groups based on Rankin score (group 1: score 0-2, and group 2: score 3 or more). Blood samples were taken to measure MPV. Severity of ischemic stroke was assessed by the Modified Rankin scale.

Results: The MPV value was higher and more significant in group 2 than group 1 (9.36+/-0.95 versus 8.55+/-0.65, p<0.001). Also, the mean platelet count was significantly lower in group 2 (238.8+/-89.2 versus 283.7+/-59.2, p=0.020). After controlling for the risk profile associated with ischemic stroke in the multivariate logistic regression model, the effect of MPV in ischemic stroke remained statistically significant (p=0.012). The area under the ROC curve was 0.77, indicating the high discriminative value of MPV for predicting severe ischemic stroke based on Rankin score >/= 3 from mild stroke.

Conclusion: The MPV is associated with ischemic stroke severity and has a high value for discriminating severe from mild ischemic stroke.

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