Evaluation of platelet indices in Acute Coronary Syndromes and Diabetes Mellitus.
Keywords:
Acute coronary syndromes, Mean platelet volume
Abstract
Background: Acute Coronary Syndrome (ACS) is the most common cause of adult mortality worldwide. Atheromatous plaque with superimposed thrombus is the commonest underlying cause. Platelets play a pivotal role initiating a thrombus, larger platelets being metabolically more active than the smaller ones. Hence the aim is to study the changes in platelet volume indices and platelet count in acute coronary syndromes and diabetes mellitus.Methods: This was a comparative study of 120 people (60 controls, 60 with ACS).ACS patients were subdivided as those with and without diabetes. Blood was collected in EDTA anticoagulated tubes.The platelet indices and platelet count were assayed using 8 part hematology analyzer (HORIBA) and compared among the groups.Result: Mean platelet volume (MPV) and platelet distribution width (PDW) were significantly raised in ACS patients, being higher in ST elevation Myocardial infarction(STEMI) followed by Non-ST elevation Myocardial infarction( NSTEMI), unstable angina(UA) and controls. The mean values of MPV and PDW were 8.86fl and 15.24% in STEMI, 8.76fl and 14.62% in NSTEMI, 8.17fl and 13.54% in UA, 8.04fL and 12.74% in controls respectively. Plateletcrit and platelet count did not show significant variation among the groups. Both MPV and PDW were higher in diabetic ACS patients (8.66 fl and 15.71% ) than the non-diabetics(8.17 fl and 14.2% ).Conclusion: Patients with acute coronary syndromes and diabetes had higher MPV and PDW compared to the controls. Measurements of platelet volume indices may be of some benefit in detecting those patients at higher risk for acute coronary events.References
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Platelet volume indices in patients with coronary artery disease and acute myocardial infarction: an Indian scenario. J Clin Pathol 2006;59:146–9.
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15. Chu SG, Becker MD, 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. J. Thromb Haemost 2009;8:148–56.
16. Slavka G, Perkmann T, Haslacher H, Greisenegger S, Marsik C,Wagner OF .Mean Platelet Volume May Represent a Predictive Parameter for Overall Vascular Mortality and Ischemic Heart Disease. Arterioscler Thromb Vasc Biol. 2011;31:1215-8.
17. Bowles KM, Cooke LJ, Richards EM, Baglin T. Platelet size has diagnostic predictive value in patients with thrombocytopenia. Clin Lab Haematol 2005;27:370-3.
18.Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia 2010;14:28-32.
19. Briggs C, Kunka S, Hart D, Oguni S, Machin SJ. Assessment of an immature platelet fraction (IPF) in peripheral thrombocytopenia. Br J Haematol 2004;126:96–9.
20. Papanas N, Symeonidis G, Maltezos E, Mavridis G, Karavageli E, Vosnakidis T. Mean platelet volume in patients with type 2 diabetes mellitus. Platelets 2004;15:475-8.
21. Hekimsoy Z, Payzinb B, Ornek T, Kandogan G. Mean platelet volume in type 2 diabetic patients. J Diabetes Complications. 2004;18:173–6.
22. Badiger R, Hosalli A, Ashwin S, Dinesha SV, Abhishek, Vijayalakshmi. Platelet indices in patients of acute coronary syndrome patients in tertiary care hospital. International Journal of Applied Research 2015;1:731-4.
2. Gupta R. Burden of coronary heart disease in India. Indian Heart J 2005;57:632-8
3. Obeidi SR, Ahmedm SH, Obeid FA. Evaluation of Platelet Indices in Patients with Acute Coronary Syndrome. Mustansiriya Medical Journal 2013; 12 :58 -64.
4. Kumar V, Abbas AK, Fauselto N, Aster JC. Robbins and Cotran Pathologic Basis of Disease. Eighth edition. New Delhi.2010:547-558.
5. Machin SJ, Briggs C. Mean platelet volume: a quick, easy determinant of thrombotic risk? J Thromb Haemost 2010;8:146–7.
6. Manchanda J, Potekar RM, Badiger S, Tiwari A.The study of platelet indices in acute coronary syndromes. Annals of pathology and laboratory medicine 2015;2:30-5.
7. Bray PF .Platelet Hyperreactivity: Predictive and intrinsic properties. Hematol Oncol Clin North Am. 2007;21:633–6.
8. Costa SC, de Matos Vinagre CG, Chacra APM , de Azevedo MRA. Platelet Indices in Patients with Acute Coronary Syndrome. Journal of Biosciences and Medicines 2015;3:71-6.
9. Pipliwal PS, Singh G, Ishran R, Bansal S. Mean platelet volume and other platelet volume indices in patients with acute myocardial infarction: A case control study. Journal of Dental and Medical Sciences Volume 2015;14: 35-8.
10. Khandekar MM, Khurana AS, Deshmukh SD, Kakrani A L, Katdare A D, Inamdar A K
Platelet volume indices in patients with coronary artery disease and acute myocardial infarction: an Indian scenario. J Clin Pathol 2006;59:146–9.
11. Assiri AS, Jamil AM, Mahfouz AA, Mahmoud ZS, Ghallab M. Diagnostic importance of platelet parameters in patients with acute coronary syndrome admitted to a tertiary care hospital in southwest region, Saudi Arabia.J Saudi Heart Assoc 2012;24:17–21.
12. Yaghoubi A, Golmohamadi Z, Alizadehasl A, Azarfarin R. Role of platelet parameters and haematological indices in myocardial infarction and unstable angina. J Pak Med Assoc 2013;63:1133-7.
13. Balli M, Taşolar H, Çetin M, Cagliyan CE, Gözükara MY, Yilmaz M et al. Relationship of platelet indices with acute stent thrombosis in patients with acute coronary syndrome. Postep Kardiol Inter 2015;11:224–9.
14. Ranjith MP, DivyaRaj R, Mathew D et al. Mean platelet volume and cardiovascular outcomes in acute myocardial infarction. Heart Asia 2016;8:16–20.
15. Chu SG, Becker MD, 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. J. Thromb Haemost 2009;8:148–56.
16. Slavka G, Perkmann T, Haslacher H, Greisenegger S, Marsik C,Wagner OF .Mean Platelet Volume May Represent a Predictive Parameter for Overall Vascular Mortality and Ischemic Heart Disease. Arterioscler Thromb Vasc Biol. 2011;31:1215-8.
17. Bowles KM, Cooke LJ, Richards EM, Baglin T. Platelet size has diagnostic predictive value in patients with thrombocytopenia. Clin Lab Haematol 2005;27:370-3.
18.Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia 2010;14:28-32.
19. Briggs C, Kunka S, Hart D, Oguni S, Machin SJ. Assessment of an immature platelet fraction (IPF) in peripheral thrombocytopenia. Br J Haematol 2004;126:96–9.
20. Papanas N, Symeonidis G, Maltezos E, Mavridis G, Karavageli E, Vosnakidis T. Mean platelet volume in patients with type 2 diabetes mellitus. Platelets 2004;15:475-8.
21. Hekimsoy Z, Payzinb B, Ornek T, Kandogan G. Mean platelet volume in type 2 diabetic patients. J Diabetes Complications. 2004;18:173–6.
22. Badiger R, Hosalli A, Ashwin S, Dinesha SV, Abhishek, Vijayalakshmi. Platelet indices in patients of acute coronary syndrome patients in tertiary care hospital. International Journal of Applied Research 2015;1:731-4.
Published
2017-01-02
Section
Original Article
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