The study of platelet indices in acute coronary syndromes

  • R M Potekar
  • Sharan Badiger
  • Abhishek Tiwari
Keywords: Acute Coronary Syndrome, Platelet Indices, Mean Platelet Volume.


Background: Platelets have been implicated in the pathogenesis of cardiovascular disorders including atherosclerosis and its complications such as acute myocardial infarction (MI), unstable angina and sudden cardiac death. Platelet indices correlates with functional status of platelets and is an emerging risk marker for atherothrombosisMethods: A prospective hospital based study was carried out on 175 cases diagnosed with Acute Coronary Syndromes and 175 controls from October 2011 to March 2013 considering the inclusion and exclusion criteria.Results: The incidence of ACS in males (62.86%) was more as compared to females (37.14%).The average age with which the patient presented with ACS was 57.76 ± 13.19 years. The commonest manifestation of ACS was ST elevation MI. Analysis of PVI indicated MPV & PDW as significant risk factor for developing a myocardial infarction. This was in concordance with the elevated cardiac enzymes levels.Conclusion: The study concludes that Platelet Indices especially MPV & PDW is raised in patients who have suffered STEMI & NSTEMI as compared with patients diagnosed with unstable angina.


1. Shah SN, Anand MP, Billimoria AR, Kamath SA, Karnad DR et al. API textbook of Medicine. Eighth edition. New Delhi. 2008:507-526.
2. Fauci AS, Kasper DL, Longo DL, Braunwald E, Hauser S et al. Harrison’s Principles of Internal Medicine. Seventeenth edition. New Delhi. Mc Graw Hill Medical. 2008(2):1514-1530.
3. Kaito K, Otsubo H, Usui N, Yoshida M, Tanno J, Kurihara E et al. Platelet size deviation width, platelet large cell ratio, and mean platelet volume have sufficient sensitivity and specificity in the diagnosis of immune thrombocytopenia. British Journal of Haematology 2005;128: 698- 702.
4. Khandekar MM, Khurana AS, Deshmukh SD, Kakrani AL, Katdare AD et al. Platelet volume indices in patients with coronary artery disease and acute myocardial infarction. J Clin Pathol 2006;59:146-149.
5. Lippi G, Filippozzi L, Salvagno GL, Montagnana M, Franchini M et al. Increased Mean Platelet Volume with Acute Coronary Syndromes. Arch Pathol Lab Med 2009;133:1441-3.
6. Kumar V, Abbas AK, Fauselto N, Aster JC. Robbins and Cotran Pathologic Basis of Disease. Eighth edition. New Delhi.2010:547-558.
7. Park K. Park’s Textbook of preventive & social medicine. Twenty Second edition. Jabalpur. Banarsibas Bhanot.2013:286-290.
8. Obeidi SR, Ahmedm SH, Obeid FA. Evaluation of Platelet Indices in Patients with Acute Coronary Syndrome. Mustansiriya Medical Journal 2013; 12 :58 -64.
9. O’Brien J, Alexander S, Robert J, Joseph J, Stanley M. Small subcutaneous doses of heparin in prevention of Venous thrombosis. N Engl J Med 1973;288:545-551.
10. Cameron HA, Phillips R, Ibbotson RM, Carson PH. Platelet size in Myocardial Infarction. Br Med J 1983;287:449-451.
11. Martin JF, Bath PM, Burr ML. Influence of platelet size on outcome after MI. Lancet. 1991;338:1409- 1411.
12. Martin JF, Trowbridge EA, Salmon G, et al. The biological significance of platelet volume: its rela-tionship to bleeding time, platelet thromboxane B2 production and megakaryocyte nuclear DNA concen-tration. Thromb Res. 1983;32: 443-460
13. Smyth D, Martin J, Michaelis L. Inhibition of platelet activity by S-nitrosoglutathione during coronary an-gioplasty. Eur J Clin Invest 1993; 361:67-73.
14. Pizzulli L, Yang A, Martin JF, Luderitz B. Changes in platelet size and count in unstable angina compared to stable angina or non-cardiac chest pain. European Heart Journal 1998;19: 80-4.
15. Chu SG, Becker RC, Berger PB, Bhatt DL, Eikelboom JW et al. Mean platelet volume as a predictor of car-diovascular risk:a systematic review and meta-analysis. J Thromb Haemost 2010;8:148-56.
16. Khode V, Sindhur J, Kanbur D, Ruikar K, Nallulwar S. Mean platelet volume and platelet volume indices in patients with stable coronary artery disease and acute myocardial infarction : A case control study. J Car-diovasc Dis Res. 2012;3:272-275
17. Endler G, Klimesch A, Plassmann HS, Schillinger M, Exner M et al. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. British Journal of Haematology 2002;117: 399-404.
18. Turnbull F. Effects of different blood-pressure lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet. 2003;362: 1527-1535.
19. Mirzaie AZ, Abolhasani M, Ahmadinejad B, Panahi M. Platelet count and MPV, routinely measured but ignored parameters used in conjunction with the diagnosis of acute coronary syndrome: single study center in Iranian population. MJIRI,2010; 26:17-21.
20. Nadar SK, Blann AD, Kamath S et al. Platelet indexes in relation to target organ damage in high-risk hypertensive patients:a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) J Am Coll Cadiol. 2004;44:415-422.
21. Bhayana A, Joshi D. Is large platelet size a risk factor for acute coronary syndrome : A retrospective case-control study. J MGIMS, 2009;14: 52 -5.
22. Gawaz M .Role of platelets in coronary thrombosis and reperfusion of ischemic myocardium. Cardiovascular Research.2004;61:498–511.
23. Linden MD, Furman MI, Frelinger AI, Barnard MR, Przyklenk SK, Michelson AD. Indices of platelet ac-tivation and the stability of coronary artery disease. Journal of Thrombosis and Haemostasis,2007; 5: 761–765.
24. Chu H, Chen WL, Huang CC, Huang HY, Kuo HY, Gau CM, et al. Diagnostic performance of mean platelet volume for patients with acute coronary syndrome visiting an emergency department with acute chest pain: the Chinese scenario. Emerg Med J 2011;28: 569-74.
25. Mathur A, Robinson MS, Cotton J, Martin JF, Erusa-limsky JD. Platelet reactivity in acute coronary syn-dromes: evidence for differences in platelet behaviour between unstable angina and myocardial infarction. Thromb Haemost 2001; 85: 989-94.
26. Senaran H, Ileri M, Altinbas A, Kosar A, Yetkin E, Oztürk M, et al. Thrombopoietin and mean platelet volume in coronary artery disease. Clin Cardiol 2001; 24: 405-8.
Original Article

Most read articles by the same author(s)