Study of Platelet and Its Indices in Acute Coronary Syndrome

Background: Approximately 10-15% of acute chest pain is secondary to ACS which occur due to sudden blockage in a coronary artery the blood supply to the heart muscles get reduced signicantly or cuts off completely. ACS is a life-threatening condition that requires urgent intervention where saving time in diagnosis means saving cardiac muscles. Aims and Objectives: To study platelet indices in acute coronary syndrome and non acute coronary syndrome and to explore the role of mean platelet volume as an additional marker in diagnostic workup of acute coronary syndrome. Material and Methods: This cross-sectional, comparative & observational study was conducted in Department of Medicine, MGM Medical College and Hospital, Navi Mumbai from December 2018 – October 2020. A total of 102 patients presented with chest pain in the Emergency Department and diagnosed as having either ACS or NON-ACS were included. Results: ACS predominantly affects the male population i.e. 73.53% in the present study. STEMI was present in 78.43% than NSTEMI 19.61%. Diabetes was present in 20.59% and hypertension in 27.45% patients. Mean Hb was higher in the ACS group than in the NON-ACS group (p value: 0.001). Similarly, mean TLC, MPV, PDW, P-LCR and Mean Trop T was higher in the ACS group than in the NON-ACS group (p value: 0.001). Mean EF was lower in the ACS group than in the NON-ACS group (p <0.0001). The area under the ROC curve for classifying ACS and Non-ACS using Platelets as marker was 57.3% (p value: 0.206). A threshold value of Platelets ≥ 2.59 for ACS patients yields a sensitivity of 54.90%, Specicity of 50.98%, PPV of 52.83%, NPV of 53.06% and Accuracy of 52.94%. The area under the ROC curve for classifying ACS and Non-ACS using MPV as marker was 74.7% (P value: < 0.001). A threshold value of MPV ≥ 10.1 for ACS patients yields a sensitivity of 76.47%, Specicity of 64.71%, PPV of 68.42%, NPV of 73.33% and Accuracy of 70.59%. For MPV ≥ 10.1, the odds in favour of ACS was 5.958 i.e., the chances of ACS is 5.95 times that of Non-ACS. Conclusion: It can be concluded from the present study that the platelet indices, viz, MPV, PDW and P-LCR, are higher in ACS than in NON-ACS. Thus, they may be used to differentiate the ACS cases. More research needs to be done in this regard, to develop the platelet indices as an early diagnostic tool for the ACS cases, especially in a limited resource country, like India.