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An increased mean platelet volume (MPV) is an early marker of platelet activation. Activated platelets play a role in atherogenesis, inflammation and atherothrombosis. Chronic obstructive pulmonary disease (COPD) is associated with cardiovascular disease-related mortality. The aim of the study is to measure the MPV in patients with stable and exacerbated COPD.We investigated the peripheral blood cell count parameters, C-reactive protein (CRP), fibrinogen, lung function parameters and arterial blood gas analysis in patients with COPD and in controls. Seventy participants were investigated at admission for an acute exacerbation of COPD and reassessed when stable. Seventy controls were matched for age, gender, body mass index, medication use and smoking.Participants with an exacerbation of COPD had lower MPV and higher CRP, white blood cells (WBC) and fibrinogen compared with when in stable phase of COPD and controls. MPV was also lower in patients in stable phase COPD compared with controls. Negative correlations between MPV and CRP, and between MPV and platelet count were present in patients in stable and exacerbation of COPD.The findings show that COPD patients, during acute exacerbation and in stable phase, have lower MPV compared with healthy controls; the MPV increase once patients have recovered from their exacerbation of COPD.The study investigates MPV in patients with stable COPD. MPV is reduced in stable COPD compared with controls. The MPV decreased further in acute exacerbation.