Increased mean platelet volume in patients with acute coronary syndromes.

CONTEXT: Despite remarkable progress, the diagnosis of acute coronary syndromes (ACS) is still challenging. OBJECTIVE: The mean platelet volume (MPV), a simple and reliable indicator of platelet size that correlates with platelet activation, might be an emerging cardiovascular risk marker and potentially helpful in stratifying cardiovascular risk. DESIGN: We analyzed MPV values in 2304 adult patients who were consecutively admitted during a 1-year period to the emergency department of the University Hospital of Verona for chest pain suggestive of ACS. In all patients, a baseline blood sample was collected for routine hematologic testing, whereas cardiac troponin T measurements were collected both at baseline and after 4, 6, and 12 hours. RESULTS: A total of 456 patients (19.8% of total) had ACS. These patients, all having cardiac troponin T levels of 0.03 ng/mL or greater in addition to ischemic electrocardiographic changes, had higher MPV values than non-ACS patients with normal cardiac troponin T levels (median, 8.0 fL 5th to 95th percentiles, 6.7-10.0 fL versus median, 7.4 fL 5th to 95th percentiles, 6.5-9.5 fL; P < .001). The diagnostic accuracy of MPV, calculated as the area under the curve by the receiver operating characteristic analysis, was 0.661 (P < .001). At the 9.0-fL cutoff, the negative and positive predictive values of MPV were 83% and 43%, respectively. CONCLUSIONS: Because MPV is a simple and inexpensive laboratory measurement, it might be considered a useful rule-out test along with other conventional cardiac biomarkers for the risk stratification of ACS patients admitted to the emergency departments.