Prognostic value of mean platelet volume and platelet distribution width for the outcomes of patients with acute ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

Objective: To investigate the impact of mean platelet distribution width (PDW) and mean platelet volume (MPV) on the prognosis of patients with acute ST-segment elevation myocardial infarction (STEMI).Methods: A total of 435 patients with acute STEMI, admitted from November 2018 to March 2023, were included.Demographic and clinical data were collected from medical records.Patients were grouped as "High PDW" (n = 184), "Low PDW" (n = 251), "Low MPV" (n = 320) and "High MPV" (n = 115) based on the cut-off values.In addition, patients with elevated PDW and MPV were assigned a score of 2, those with elevation in either marker received a score of 1, and those without elevation in either marker received a score of 0. Based on these scores, patients were divided into three groups: group 0, group 1, and group 2. Clinical data of patients in different groups were compared.Multivariate logistic regression analysis and Cox proportional hazards models were used to identify independent predictors of in-hospital mortality and long-term major adverse cardiovascular events (MACEs), respectively.The Kaplan-Meier method was used to construct the cumulative survival curve for long-term MACEs.Results: Significant differences were observed between the High PDW and Low PDW groups in terms of gender distribution, diabetes, platelet count (PLT), PDW, MPV, D-dimer, left ventricular ejection fraction (LVEF), in-hospital mortality, MACEs, and follow-up duration (all P < 0.05).Similarly, significant differences were noted between the High MPV and Low MPV groups in gender distribution, PDW, MPV, D-dimer, SYNTAX score, in-hospital mortality, MACEs, and follow-up duration (all P < 0.05).Among the three groups with scores of 0, 1, and 2, significant differences were found in gender distribution, presence of diabetes, PLT, PDW, MPV, LVEF, SYNTAX score, in-hospital mortality, MACEs, and follow-up duration (all P < 0.05).Multivariate logistic regression analysis revealed that LVEF, SYNTAX score, D-dimer, creatinine, high PDW (in Model 1), and high MPV (in Model 2) were independent predictors of in-hospital death.In Model 3, LVEF, SYNTAX score, D-dimer, creatinine, GROUP(1), and GROUP(2) were independent predictors of in-hospital death.The Cox proportional hazards model showed that gender and high PDW value were independent predictors of MACEs in Model 1, high MPV value was an independent predictor of MACEs in Model 2, and GROUP(1) and GROUP(2) were independent predictors of MACEs in Model 3. Kaplan-Meier curves demonstrated significantly different survival rates based on PDW and MPV levels, as well as GROUP scores.Conclusion: PDW combined with MPV provides valuable prognostic information for the outcomes of patients with acute STEMI undergoing PCI.