Abstract

Previous studies have documented high platelet indices with low platelet count in patients with acute coronary syndrome as compared to those with non cardiac chest pain. This study aimed to assess the predictive value of platelet indices (MPV, PDW, P-LCR) in patients of ACS as compared to the patients of non-cardiac chest pain. Methodology: This study was conducted as a facility based cross sectional observational study in Department of Medicine during the study period of 18 months. Detailed history was obtained and patients were categorized to be suffering from ACS and Non ACS based upon ECG, Troponin I and CKMB levels. Apart from this, platelet indices such as MPV, PDW and P-LCR were assessed using CBC. Results: This study was conducted on a total of 150 cases with mean age of 55.59±15.141 years. Acute coronary syndrome was documented in 58.7% cases. We observed significantly higher level of MPV, PDW and P-LCR in cases with acute coronary syndrome as compared to those of non cardiac chest pain (p<0.05). Area under the curve was 0.833, suggesting good agreement for MPV with 92% sensitivity and 53.2% specificity at the cut off of 8.50 fl. Similarly, area under the curve was 0.755 and 0.731 for PDW and P-LCR suggesting fair accuracy in predicting ACS (p<0.05). Conclusions:Platelet indices, particularly Mean platelet volume, platelet distribution width and P-LCR are simple, reliable and cost effective measures that are helpful in predicting the risk of ACS n cases presenting with chest pain with good accuracy. These indices are observed to be higher in patients with Acute coronary syndrome and may help in risk stratification among patients with ACS. Mean platelet volume is best predictor of ACS with good diagnostic accuracy

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