Diagnostic Accuracy of Mean Platelet Volume in the Diagnosis of Acute Coronary Syndromes among Patients with Acute Chest Pain at the Emergency Room of Philippine Heart Center

Abstract

Introduction. Mean platelet volume (MPV), an index for platelet size, is believed to be associated with acute coronary syndromes (ACS). This study aims to establish the association of MPV and ACS in the local setting and to further evaluate the diagnostic accuracy of MPV in the detection of ACS.

Methodology.  Adult patients presented with chest pain seen at the ER were submitted for complete blood count (CBC). The specimen was processed for MPV and platelet count using Beckman-Coulter ACT 5Diff hematology auto-analyzer.  Patients were grouped into ACS and non-ACS. Independent t-test was used to determine statistically significant difference between these two groups.  Diagnostic cut-off point was determined using the area under the curve.

Results.  A total of 150 adult patients were examined for MPV and platelet counts. There was a significant difference of MPV between the two groups at p value <0.0001. The MPV of patients with ACS was increased at 8.3 fL compared to 7.3 fL in patients not diagnosed with ACS. Cut-off points predictive of ACS based on the area under the curve of the ROC curve revealed a significant test (AOC is equal to 0.868 95% CI (0.812-0.924) p = <0.0001). At cut-off point of 8.4 fL, the positive predictive value and specificity for ACS were 100%, sensitivity of 43.6 and a negative predictive value of 46.2. The number of platelets was increased in non-ACS group.

Conclusion. The MPV of acute chest patients diagnosed with ACS was significantly higher compared to patients not diagnosed with ACS. Increased MPV at 8.4 fL was highly specific and predictive of ACS. However, the sensitivity and negative predictive value were low.  Platelet count of non-ACS group was increased.