Significance of platelet volume indices in acute coronary syndrome

Acute coronary syndrome (ACS) is a leading global cause of mortality, driven by platelet-mediated atherothrombosis; early diagnosis improves outcomes. This study aimed to evaluate platelet volume indices, including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR), for ACS diagnosis and their prognostic value for ICU stay and in-hospital mortality. Prospective comparative study of 638 patients (381 ACS, 257 stable angina). Venous blood samples collected in EDTA tubes were analyzed for platelet count and indices within 30 minutes; 12-lead ECG and cardiac biomarkers were assessed. ICU stay and in-hospital mortality were recorded. Platelet volume indices were significantly higher in ACS patients with significant diagnostic accuracy for ACS (p-value: <0.001). Platelet counts were insignificantly lower in ACS patients (P-value: 0.189). No significant correlations between MPV, PDW, and P-LCR in ACS patients and their length of ICU stay (P-value: 0.387, 0.433, and 0.697) or incidence of in-hospital mortality (P-value: 0.125, 0.118, and 0.169), respectively. Platelet volume indices, inexpensive and widely available, effectively discriminate ACS from stable angina as early markers but lack short-term prognostic utility for ICU stay or mortality.