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Research Paper | Cardiology Science | India | Volume 12 Issue 5, May 2023 | Rating: 5.4 / 10
Impact of Mean Platelet Volume on Outcomes among Patients under 45 Years Presenting with First Episode of Acute Coronary Syndrome
Vivek Chakrapani Warrier | Haridasan Vellani | Gopalan Nair Rajesh
Abstract: Introduction: There is an increased tendency for acute coronary syndrome (ACS) among young population in the recent years. Arterial thrombosis is the key process in the development of ACS, in which platelets play a pivotal role. Mean platelet volume which has direct correlation with platelet activity can be a useful prognostic marker for patients with ACS. Detecting the risk factors associated with worse outcome will be useful to prevent major adverse cardiac and cerebrovascular events in young patients with ACS. Objectives: To study the impact of mean platelet volume (MPV) at the time of admission on six - month major adverse cardiac events (MACE) among patients less than 45years presenting with first episode of Acute Coronary syndrome. Methods: It is a prospective observational study conducted in the department of cardiology, Government medical college Kozhikode from October 2021 to September 2022. A total of 160 patients were included in the study. Results: The study population was classified into tertiles based on their MPV range (Group 1= <9.6fl, Group 2= 9.7 to 11.5 fl and Group 3 = >11.5 fl) and the number of patients in each group were: first tertile (N=66) second tertile (N=84) and third tertile (N=10), with a mean age of 37.94 ? 4.09, 37.44 ? 4.3, 35.4 ? 3.69 respectively. Majority of the patients were in the age group of 35 - 40 years in all the three tertile. Gender distribution showed a majority of male participants. Comorbidities like diabetes, hypertension and dyslipidemia were commonly seen. Smoking and alcoholism were the common addictions seen in the study participants, but there was no significant difference between the tertiles. NSTEMI was the most common type of MI in patients of first tertilewhile STEMI was the most common MI in the other 2 groups. There was a statistically significant difference in the type of MI between the 3 groups (P value=0.007). Ejection fraction was >50 for majority of the patients of 1st & 2nd tertiles whereas higher number of participants in the 3rd tertile had ejection fraction between 40 - 50 (P value=0.004). Majority of the study participants belonged to Killip & TIMI class I in Group 1 & 2. patients in 3rd tertile had more participants in Killip & TIMI class II. The MPV at baseline and follow up was compared and the values were comparable in group 1 but there was a statistically significant decrease in MPV in group 2 & 3 (P value <0.05). Single vessel disease (SVD) was the most common angiogram finding across the 3 groups with a significantly higher proportion amongst the third tertile (P value =0.01). Multivariate regression showed model, baseline MPV, Killip & TIMI class were significant predictors of follow up MPV values. Conclusion: Patients with higher MPV values had severe disease at presentation and developed adverse cardiovascular events on follow up. MPV is a simple and inexpensive laboratory test that could be used in concert with other standard biochemical cardiac markers to help predict the risk of significant cardiovascular events in young population
Keywords: Mean platelet volume (MPV), Acute Coronary Syndrome (ACS), NSTEMI, STEMI, biochemical cardiac markers
Edition: Volume 12 Issue 5, May 2023,
Pages: 1577 - 1582