Analysis of Platelet Morphological Parameters as Clinical Risk Stratification in Acute Coronary Syndrome

Area of Science:

• Cardiology
• Hematology
• Biomarker Discovery

Background:

• Platelet activation is key in acute coronary syndrome (ACS) pathogenesis.
• Platelet morphological parameters, including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR), are emerging as significant biomarkers.
• These parameters show potential in predicting ACS severity and patient prognosis.

Purpose of the Study:

• To investigate the relationship between MPV, PDW, and P-LCR and the severity of coronary artery lesions in ACS patients.
• To evaluate the predictive value of these platelet parameters for adverse clinical outcomes.
• To assess the diagnostic performance of these parameters in ACS.

Main Methods:

• A prospective observational study involving 134 ACS patients and 50 healthy controls.
• Measurement of MPV, PDW, and P-LCR at admission.
• Coronary artery lesion severity assessed using the Gensini score via coronary angiography.
• Multivariate logistic regression and ROC curve analysis to determine predictive and diagnostic values.

Main Results:

• ACS patients exhibited significantly higher MPV, PDW, and P-LCR compared to controls (p < 0.001).
• Strong positive correlations were observed between these platelet parameters and the Gensini score (r = 0.778–0.800; p < 0.001).
• MPV, PDW, and P-LCR were identified as independent predictors of adverse prognosis (p < 0.001).
• Combined assessment of MPV, PDW, and P-LCR demonstrated superior predictive accuracy (AUC = 0.927).

Conclusions:

• Elevated platelet morphological parameters are strongly linked to coronary artery lesion severity in ACS.
• These parameters serve as independent predictors of adverse outcomes in ACS patients.
• The combined evaluation of MPV, PDW, and P-LCR offers enhanced risk stratification, aiding therapeutic guidance and prognosis improvement.