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Platelet volume indices in patients with coronary artery disease and acute myocardial infarction: an Indian scenario

¹ Department of Pathology, B J Medical College and Sassoon General Hospitals, Pune, 411001, India
² Department of Pathology, B J Medical College and Sassoon General Hospitals
³ Department of Medicine, B J Medical College and Sassoon General Hospitals
⁴ Department of Cardiovascular Thoracic Surgery, B J Medical College and Sassoon General Hospitals

Correspondence to:
Dr M M Khandekar
128/1, A Paud Road Kothrud, Pune 411038, India; punein{at}vsnl.com Aims: To study platelet volume indices (PVI) in the spectrum of ischaemic heart diseases.

Methods: A total of 210 cases were studied; 94 patients had unstable angina (UA) or acute myocardial infarction (AMI) diagnosed on the basis of history, characteristic electrocardiographic changes, and increased cardiac enzyme activities. Seventy patients had stable coronary artery disease (stable CAD) or were admitted for a coronary angiography or coronary artery bypass graft procedure. The third group comprised 30 age and sex matched healthy controls with no history of heart disease and a normal electrocardiogram.

Results: All PVI—mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR)—were significantly raised in patients with AMI and UA (mean MPV, 10.43 (SD, 1.03) fL; mean PDW, 13.19 (SD, 2.34) fL; mean P-LCR, 29.4% (SD, 7.38%)) compared with those with stable CAD (mean MPV, 9.37 (SD, 0.99) fL; mean PDW, 11.35 (SD, 1.95) fL; mean P-LCR, 22.55% (SD, 6.65%)) and the control group (mean MPV, 9.2 (SD, 0.91) fL; mean PDW, 10.75 (SD, l.42) fL; mean P-LCR, 20.65% (SD, 6.14%)).

Conclusions: Larger platelets are haemostatically more active and are a risk factor for developing coronary thrombosis, leading to myocardial infarction. Patients with larger platelets can easily be identified during routine haematological analysis and could possibly benefit from preventive treatment. Thus, PVI are an important, simple, effortless, and cost effective tool that should be used and explored extensively, especially in countries such as India, for predicting the possibility of impending acute events.

Abbreviations: AMI, acute myocardial infarction; CAD, coronary artery disease; MI, myocardial infarction; MPV, mean platelet volume; PC, platelet count; PDW, platelet distribution width; P-LCR, platelet large cell ratio; PVI, platelet volume indices; UA, unstable angina

Keywords: acute myocardial infarction; coronary artery disease; mean platelet volume; platelet distribution width; platelet volume indices