Acute coronary syndrome and its impact on platelet indices: insights from a tertiary care hospital in Lahore, Pakistan
DOI:
https://doi.org/10.52442/jrmi.v12i1.889Keywords:
Acute Coronary Syndrome, Mean Platelet Volume, Platelet Count, ThrombocytopeniaAbstract
Introduction: Platelet indices serve as potential biomarkers to assess the risk associated with Acute Coronary Syndrome (ACS). The platelet count is particularly significant, showing a strong correlation with complications after percutaneous coronary intervention, such as restenosis and thrombotic events.
Objective: To determine the frequency of thrombocytopenia and abnormal mean platelet volume (MPV) in patients with Acute Coronary Syndrome.
Materials and Methods: This cross-sectional study was conducted in the Department of Pathology, King Edward Medical University, Lahore from July 21, 2022, to January 20, 2023. A total of 75 adult patients (aged 20-70 years) of both genders, diagnosed with Acute Coronary Syndrome (Unstable Angina, Non-ST Elevation Myocardial Infarction, and ST Elevation Myocardial Infarction), were included. Venous blood samples (3ml) were collected in EDTA-containing vials and analyzed within two hours using the automated XN-100 system. Platelet count and mean platelet volume (MPV) were recorded for each patient. Data were analyzed using SPSS v22 with p < 0.05 considered significant.
Results: The study included 75 patients, with an age range from 20 to 70 years (mean: 55.91 ± 8.71 years) with 57 (76%) males and 18 (24%) female patients. Majority of the patients (n=60; 80%) were between 51 and 70 years of age. Thrombocytopenia was observed in 12 (16%) patients, and abnormal MPV was noted in 22 (29.33%) patients. No statistically significant association was found between patient age and platelet abnormalities (p>0.05).
Conclusion: The study concluded that thrombocytopenia and abnormal mean platelet volume (MPV) occur at a significantly higher frequency among patients with Acute Coronary Syndrome.
References
Bhatt DL, Lopes RD, Harrington RA. Diagnosis and treatment of acute coronary syndromes: a review. JAMA. 2022 Feb 15;327(7):662-75. Doi: 10.1001/jama.2022.0358.
Młynarska E, Czarnik W, Fularski P, Hajdys J, Majchrowicz G, Stabrawa M, et al. From atherosclerotic plaque to myocardial infarction—The leading cause of coronary artery occlusion. Int J Mol Sci. 2024 Jul 2;25(13):7295. Doi: 10.3390/ijms25137295.
Scherlinger M, Richez C, Tsokos GC, Boilard E, Blanco P. The role of platelets in immune-mediated inflammatory diseases. Nature Rev Immunol. 2023 Aug;23(8):495-510. Doi: 10.1038/s41577-023-00834-4.
Nathan SS, Varadaraj P, Nallusamy G, Reddy KS, Senthilnathan S. The Significance of Platelet Indices in the Evaluation of Thrombocytopenia. Cureus. 2024 Jul 30;16(7). Doi: 10.7759/cureus.65756.
Zheng YY, Wang L, Shi Q. Mean platelet volume (MPV) and platelet distribution width (PDW) predict clinical outcome of acute ischemic stroke: A systematic review and meta-analysis. J Clin Neurosci. 2022 Jul 1; 101: 221-7. Doi: 10.1016/j.jocn.2022.05.019.
Yoon I, Han JH, Jeon HJ. Advances in platelet-dysfunction diagnostic technologies. Biomolecules. 2024 Jun;14(6):714. Doi: 10.3390/biom14060714.
Kamran H, Jneid H, Kayani WT, Virani SS, Levine GN, Nambi V, Khalid U. Oral antiplatelet therapy after acute coronary syndrome: a review. JAMA. 2021 Apr 20;325(15):1545-55. Doi:10.1001/jama.2021.0716.
Scridon A. Platelets and their role in hemostasis and thrombosis—From physiology to pathophysiology and therapeutic implications. Int J Mol Sci. 2022 Oct 23;23(21):12772. Doi: 10.3390/ijms232112772.
Leiva, Orly, et al. "Risk factors for death or cardiovascular events after acute coronary syndrome in patients with myeloproliferative neoplasms." Hematology Reports 15.2 (2023): 398-404. Doi: 10.3390/hematolrep15020040.
Damluji AA, Forman DE, Wang TY, Chikwe J, Kunadian V, Rich MW, et al. Management of acute coronary syndrome in the older adult population: a scientific statement from the American Heart Association. Circulation. 2023 Jan 17;147(3):e32-62. Doi: 10.1161/CIR.0000000000001112.
Chao CJ, Shanbhag A, Chiang CC, Girardo ME, Seri AR, Khalid MU, Rayfield C, O'Shea MP, Fatunde O, Fortuin FD. Baseline thrombocytopenia in acute coronary syndrome: The lower, the worse. Int J Cardiol. 2021 Jun 1; 332:1-7. Doi: 10.1016/j.ijcard.2021.03.059.
Islam MA, Siddiqui NI, Begum MS, Bhuiyan AS, Rahman MA, Ahammed SU. Diagnostic Importance of Platelet in Patients with Acute Coronary Syndrome Admitted in Mymensingh Medical College Hospital. Mymensingh Med J. 2017 Jan 1;26(1):61-7. PMID: 28260757
Biswal S, Pandit VR, Meher J, Gupta AK, Rokkam R. Clinical Significance of Platelet Indices (Mean Platelet Volume and Mean Platelet Volume-to-lymphocyte Ratio) in Acute Coronary Syndrome: A Hospital-based Observational Study. J Assoc Physicians India. 2024 Sep;72(9):43-8. Doi: 10.59556/japi.72.0581.
Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean platelet volume (MPV): new perspectives for an old marker in the course and prognosis of inflammatory conditions. Mediators of inflammation. 2019;2019(1):9213074. Doi: 10.1155/2019/9213074.
Khode V, Sindhur J, Kanbur D, Ruikar K, Nallulwar S. Mean platelet volume and other platelet volume indices in patients with stable coronary artery disease and acute myocardial infarction: A case control study. J Cardiovasc Dis Res. 2012 Oct 1;3(4):272-5. Doi: 10.4103/0975-3583.102694.
Knauss E. Platelet Activation in Venous Thrombosis is Driven by Protease Activated Receptor 4 (PAR4), Case Western Reserve University ProQuest Dissertation & Theses, 2024. 31629074.
Xie E, Wu Y, Ye Z, Gao Y, Zheng J. High Fibrinogen Levels with Diabetes Mellitus are Associated with All-Cause and Cardiovascular Mortality in Patients with End-Stage Renal Disease and Acute Coronary Syndrome. J Inflamm Res. 2024 Dec 31:7409-22. Doi: 10.2147/JIR.S483001.
Chu SG, Becker RC, Berger PB, Bhatt DL, Eikelboom JW, Konkle B, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. Journal of Thrombosis and Haemostasis. 2010;8(1):148-56. Doi: 10.1111/j.1538-7836.2009.03584.x.
Manchanda J, Potekar RM, Badiger S, Tiwari A. The study of platelet indices in acute coronary syndromes. Annals Pathol Lab Med. 2015; 2(1):A30-A35. Available at https://pacificejournals.com/journal/index.php/apalm/article/view/139.
Huczek Z, Kochman J, Filipiak KJ, Horszczaruk GJ, Grabowski M, Piatkowski R, et al. Mean platelet volume on admission predicts impaired reperfusion and long-term mortality in acute myocardial infarction treated with primary percutaneous coronary intervention. J Am Coll Cardiol. 2005;46(2):284-90. Doi:10.1016/j.jacc.2005.03.065.
Ahamed H, Henry R A, Pai. R. Association of mean platelet volume and acute coronary syndrome. Int J Res Med Sci. 2017 Apr;5(4):1217-20. Doi:10.18203/2320-6012.ijrms20170968.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Journal of Rehman Medical Institute
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
