Association of mean platelet volume and acute coronary syndrome

Abstract

Background: Acute coronary syndrome (ACS) is a set of signs and symptoms due to rupture of a plaque and are a consequence of platelet rich coronary thrombus formation. Larger platelets are haemostatically more active and and hence carry risk for developing coronary thrombosis leading to ACS. Platelet parameters especially mean platelet volume (MPV) could be used as an important and reliable marker in early detection of ACS when the patients come to emergency department with chest pain. The primary objective is to study the association between mean platelet volume and acute coronary syndrome. The secondary objectives are to analyse if there is a statistically significant difference in mean platelet volume between Non-ST elevation (NSTEMI) and ST-elevation Myocardial Infarction (STEMI) and between double vessel disease (DVD) and triple vessel disease (TVD).Methods: A total of 260 patients were included in the study depending on the inclusion and exclusion criteria. After dividing the patients with chest pain into control (Non-cardiac chest pain) and study group (ACS) which contained 130 each, venous blood was drawn and taken to haematology laboratory for analysis of MPV within 2 hrs. The statistical analysis used were mean, median, test of significance in difference (t-test) and chi-square test.Results: Mean platelet volume (MPV) was found to be higher among ACS patients (9.4868±0.85270) as compared to control (7.430±0.72172) and it was significant with a P value <0.05. It was also noticed that MPV was higher among patients with STEMI when compared to NSTEMI, 10.32±0.77932 and 9.22±0.52743 and it was statistically significant (P<0.05). Similarly, MPV between patients with triple and double vessel disease were compared and the mean MPV of 10.04±0.88738 of TVD was greater than the mean MPV of 9.22±0.67438 in DVD and was statistically significant (P<0.05).Conclusions: In this study the MPV was higher in patients with ACS than those in control group. The study also showed that there was significant difference in MPV values between people with STEMI and NSTEMI and between people with DVD and TVD. Hence it might be useful as an additional cost efficient test in conjunction with other markers in the early prediction of ACS in the emergency room. Larger platelets are haemostatically more active and hence carry risk for developing coronary thrombosis leading to ACS. Patients with increased MPV could be easily identified during routine haematological analysis and hence could play an important role in early detection of acute coronary syndrome (ACS).