Increased Mean Platelet Volume in Patients with Acute Coronary Syndromes (Clinical Report‪)‬

Acute coronary syndromes (ACS) encompass a spectrum of unstable coronary artery disease, from unstable angina to transmural myocardial infarction. (1) Despite remarkable progress in diagnosing patients with ACS, the identification of myocardial ischemia is still challenging, and physicians continue to admit the overwhelming majority of patients, often overestimating the likelihood of myocardial ischemia in low-risk patients. (2) Consensus guidelines on a universal definition of myocardial infarction have been issued recently by the International Federation of Clinical Biochemistry, European Society of Cardiology, the American College of Cardiology, and the American Heart Association and the World Heart Federation that recommend cardiac troponin I and cardiac troponin T (cTnT) measurements as the preferred biochemical cardiac biomarkers for diagnosing ACS. However, the diagnostic efficiency of cardiac troponins within 2 to 4 hours of the symptom onset is limited. (3) Therefore, laboratory biochemical tests that successfully reduce emergency department delays in hospital admissions for chest pain patients have the potential to significantly increase clinical and hospital revenues. (4) Platelet activation and aggregation have long been noticed in the pathophysiology of coronary heart disease, because platelets play a pivotal role in contributing to thrombus formation or apposition after coronary plaque rupture. (1) Mean platelet volume (MPV), a simple and reliable index of platelet size that correlates with the functional status of platelets, is an emerging risk marker for atherothrombosis. Moreover, previous evidence suggests that MPV may be a risk factor for recurrent myocardial infarction independent of such established risk factors as hypertension, dyslipidemia, increased fibrinogen, white blood cell count, or plasma viscosity. (5)