Platelet Indices as a marker of severity in Acute Coronary Syndrome patients at Qena University Hospital

Ashour, Reham; Goda, Hamdy M; AK, Mohammed; HM, Fayed

doi:10.21608/svuijm.2025.376878.2164

Platelet Indices as a marker of severity in Acute Coronary Syndrome patients at Qena University Hospital

Document Type : Original research articles

Authors

¹ Clinical and Chemical Pathology Department, Faculty of Medicine, South Valley University, Qena, Egypt.

² Internal Medicine Department, Faculty of Medicine, South Valley University, Qena, Egypt.

10.21608/svuijm.2025.376878.2164

Abstract

Background: Coronary artery disease (CAD) is the leading global cause of death, with acute coronary syndrome (ACS) being a severe form leading to myocardial injury. Platelets and lipids play a key role in thrombosis and atherogenesis. Complete blood count (CBC) ratios may predict ACS outcomes.
Objectives: To assess the relationship between platelet and inflammatory indices and the severity of ACS.
Patients and methods: This cross-sectional study involved ACS patients aged 18+. Patients were divided into groups 1 (stable CAD) and 2 (acute myocardial infarction). Clinical and laboratory assessments included ECG, echocardiography, CBC, cardiac enzymes, and inflammatory markers.
Results: Cases had significantly higher systolic blood pressure; ECG was abnormal in 95%. ST depression was present in 59% of patients, 53% had an ejection fraction (EF) of less than 50%; and the mean EF was 48.09±8.93%. Patients with EF<50% had higher platelet count (336.962±73.198 vs 246.83±54.308, P<0.0001) and increased inflammatory indices (P < 0.05), but lower mean platelet volume (MPV) (8.91±2.72 vs 11.92±3.57, P<0.0001) and lymphocyte count (2.551±1.211 vs 2.989±1.298, P=0.0297). Neutrophil platelets score (NPS) and prognostic index (PI) scores of 1 and 2 were more prevalent among ACS cases with EF of < 50% (P<0.05). Platelet distribution width (PDW) and systemic immune-inflammation index (SII) were independent positive predictors of left ventricular ejection fraction (LVEF) (P<0.0001), whereas C-reactive protein (CRP) level was a significant independent negative predictor (P<0.0001).
Conclusion: Hematologic inflammatory indices and EF were correlated in ACS patients; higher ratios are associated with systemic inflammation and reduced EF.

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