Evaluation of Platelet Parameters in Patients of Acute Coronary Syndrome

Abstract

Introduction:

Platelets play a vital role in pathogenesis of cardiovascular diseases. Platelet activation occurs before an acute coronary event, which leads to thrombus formation. Platelet which are large in size are more active metabolically and enzymatically. Large platelets produce more thromboxane A2 and glycoprotein receptors (IIb/IIIa) which also leads to development of thrombus and increase risk of Acute Coronary Syndrome (ACS). ACS includes acute myocardial infarction, unstable angina and sudden cardiac death. It is a chronic process accompanied by a cascade of platelets which result into development of thrombus formation. Platelet size and its activity correlate with platelet indices such as Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW). Increase in MPV and PDW indicate thrombus formation and facilitates early detection of acute myocardial infarction.

Aim and Objective:

Evaluation platelet parameters such as platelet count, mean platelet volume and platelet distribution width in patients of ACS and their correlation with cardiac biomarkers, clinical details and ECG findings.

Methodology:

Blood samples of cases of ACS were collected immediately after the admission in EDTA vacutainer and were analysed in five part haematology analyser. Platelet parameters were compared with clinical details, ECG findings and cardiac biomarkers.

Results:

The study included 150 cases of Acute Coronary Syndrome (ACS) with 50 age and sex matched controls. Commonest age group was 51-60 years with male preponderance. Platelet count ranged from 1.5 – 3.3 lacs/cumm with mean value of 1.7 lacs/cumm which was lower than that of control group. Mean value of MPV and PDW were higher in ACS cases than that of controls. Mean value of PC was lower while MPV and PDW were higher in Troponin I positive cases than that of Troponin I negative cases and controls. Mean PC count was lower and Mean MPV and PDW showed higher values in ST elevation myocardial infarction.

Conclusion:

Platelet parameters plays a significant role in early diagnosis of ACS and initiation of antiplatelet therapy thereby prevention of full blown acute coronary syndrome. It is  a screening test to differentiate ACS from noncardiac chest pain as well as severity and prognosis of ACS..