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Updated: Mar 14, 2026
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Platelet distribution width predicts left ventricular dysfunction in patients with acute coronary syndromes treated
Michał Kowara, Kajetan Grodecki1, Zenon Huczek
11st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland. kajetan.grodecki@gmail.com.
Insights
Platelet distribution width (PDW) can predict impaired left ventricular (LV) systolic function in acute coronary syndrome (ACS) patients. Higher PDW levels on admission are associated with reduced LV ejection fraction and increased one-year mortality risk.
Area of Science:
- Cardiology
- Hematology
- Biomarkers
Background:
- Platelets play a critical role in acute coronary syndromes (ACS).
- Platelet distribution width (PDW) is a marker of platelet reactivity, with potential for risk stratification in ACS.
- The association between PDW and left ventricular (LV) function in ACS patients has not been previously investigated.
Purpose of the Study:
- To determine if admission PDW can predict LV systolic function in ACS patients undergoing stent implantation.
- To explore the relationship between PDW and one-year mortality in this patient cohort.
Main Methods:
- 278 consecutive ACS patients undergoing stent implantation had their on-admission PDW measured.
- Echocardiography was performed within 24 hours to assess LV ejection fraction (LVEF).
- One-year all-cause mortality was tracked for all participants.
Main Results:
- A PDW > 12.8 fL predicted LVEF ≤ 35% with 81% sensitivity (AUC 0.614, p=0.0177).
- Multivariate analysis confirmed PDW independently predicts both impaired LV systolic function (LVEF ≤ 35%, PDW cut-off 12.8 fL, OR 2.81, p=0.0248) and one-year mortality (PDW cut-off 16 fL, OR 2.68, p=0.0457).
- A trend was observed for PDW predicting one-year mortality (AUC 0.608, p=0.0815).
Conclusions:
- Admission PDW is a simple, accessible predictor of impaired LV function in ACS patients.
- Further research in larger studies is needed to confirm the association between PDW and mortality.
Background:
The role of platelets in the pathophysiology of acute coronary syndromes (ACS) is undeniable, but precise relationships between platelet activity and treatment outcomes are a matter of continuant investigation. Among platelet indices, mean platelet volume (MPV) has proven to be a valuable predicting factor in cardiac patients. However, platelet distribution width (PDW) is reported to be a more specific marker of platelet reactivity. Thus, application of PDW in risk stratification of ACS treatment is an up-to-date subject of research. PDW values in the assessment of left ventricular (LV) function have not been previously studied.
Aim:
The aim of the study was to evaluate whether admission PDW can predict LV systolic function in patients with ACS treated with stent implantation.
Methods:
On-admission PDW was measured in 278 consecutive patients with diagnosis of ACS, who underwent stent(s) implantation. Echocardiogram with LV ejection fraction (LVEF) estimation was performed within 24 h of percutaneous coronary intervention. Additionally, patients were under one-year follow-up, and one-year all-cause mortality was assessed.
Results:
According to receiver-operating characteristics (ROC) analysis, a PDW value greater than 12.8 fL could predict LVEF ≤ 35% with sensitivity of 81% and specificity of 39% (AUC 0.614; p = 0.0177). Only a trend was noted in ROC for PDW and one-year mortality (AUC 0.608; p = 0.0815). Multivariate logistic regression analysis has shown that the PDW parameter correlates independently with both systolic heart failure with LVEF ≤ 35% (PDW cut-off: 12.8 fL, OR 2.8107, CI 1.1401-6.9293, p = 0.0248) and one-year mortality (PDW cut-off: 16 fL, OR 2.6750, CI 1.0190-7.0225, p = 0.0457).
Conclusions:
Admission PDW may serve as a simple and widely available predictor of impaired LV function in patients with ACS. Association between PDW and mortality needs to be confirmed in larger studies.
