Published: 2019-01-25

Mean platelet volume as a predictor of clinical outcomes in patients of acute myocardial infarction

Tejas Madavi, Pragati Bhole, M. P. Holay


Background: High levels of mean platelet volume (MPV), as an indicator of larger, more reactive platelets resulting from an increased platelet turnover, may represent a risk factor for overall vascular mortality and other cardiovascular events, including myocardial infarction (MI). The present study was undertaken to see the predictive value of MPV in accessing the clinical outcomes in acute myocardial infarction, (AMI).

Methods: Total consecutive 114 cases of AMI admitted to intensive care unit were enrolled in the study and were compared with the equal number of age and gender-matched controls. The clinical evaluation of cases was done at admission and on day 7 in terms of a) Cardiogenic shock, b) Arrhythmia and c) Effect of thrombolysis. Patients were classified according to tertile of baseline MPV.

Results: The mean age of cases was 55.56±12.19 years. Males (66.67%) were outnumbering females (33.33%) in cases and controls showing male to female ratio of 2:1. Mean MPV was 10.2±1.27fl in cases and 7.26±0.79fl in controls which was statistically significant. Correlation of MPV with cardiogenic shock, arrhythmia and mortality was significant. Correlation of MPV with risk factor shows that diabetes was the only risk factor significant in AMI. Multiple logistic regression of risk factors with mortality in AMI shows that high MPV and obesity was found to be independently associated with mortality in AMI.

Conclusions: Mean platelet volume is simple, easily available and cheap method. Serial estimation of MPV is a predictor of adverse clinical outcome in AMI so treating doctor can be more vigilant.


Arrhythmia, Mortality, Myocardial infarction, Platelet, Risk factor

Full Text:



Martin JF, Kristensen SD, Mathur A, Grove EL, Choudry FA. The causal role of megakaryocyte-platelet hyperactivity in acute coronary syndromes. Nature Reviews Cardiol. 2012;9(11):658-70.

Ranjith MP, Divya R, Mehta VK, Krishnan MG, KamalRaj R, Kavishwar A. Significance of platelet volume indices and platelet count in ischaemic heart disease. J Clin Pathol. 2009;62:830-3.

Yilmaz MB, Cihan G, Guray Y, Guray U, Kisacik HL, Sasmaz H, et al. Role of mean platelet volume in triaging acute coronary syndromes. J Thromb. 2008;26:49-54.

Slavka G, Perkmann T, Haslacher H, Greisenegger S, Marsik C, Wagner OF, Endler G. Mean platelet volume may represent a predictive parameter for overall vascular mortality and ischemic heart disease. Arterioscler Thromb Vasc Biol. 2011;31:1215–18.

Greisenegger S, Endler G, Hsieh K, Tentschert S, Mannhalter C, Lalouschek W. Is elevated mean platelet volume associated with a worse outcome in patients with acute ischemic cerebrovascular events?. Stroke. 2004 Jul 1;35(7):1688-91.

Shah B, Oberweis B, Tummala L, Amoroso N, Lobach I, Grossi E, Sedlis S, et al. Mean platelet volume is significantly associated with survival following percutaneous coronary intervention and coronary artery bypass surgery. J Am Coll Cardiol. 2012;59:E1478.

Rechciński T, Jasińska A, Foryś J, Krzemińska-Pakuła M, Wierzbowska-Drabik K, Plewka M, et al. Prognostic value of platelet indices after acute myocardial infarction treated with primary percutaneous coronary intervention. Cardiol J. 2013;20:491-8.

Khandekar MM, Khurana AS, Deshmukh SD, Kakrani AL, Katdare AD, Inamdar AK. Platelet volume indices in patients with coronary artery disease and acute myocardial infarction: an Indian scenario. J Clin Pathol. 2006;59(2):146-9.

Gonçalves SM, Gomes KB, Carvalho MDG, Magalhães HPB, Reis EA, Silva IFO. Effectiveness to identify acute myocardial infarction using the Manchester screening in patients with chest pain at the emergency service. J Clin Lab Anal. 2018:e22439.

Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, et al. Third universal definition of myocardial infarction. Eur Heart J. 2012;33(20):2551-67.

Sultan N, Sharma SK. Platelet count and mean platelet volume- key hematological indices in determination of various clinical perspectives-a review. Inter J Sci Res (IJSR). 2015;4(4):3347-50.

Huczek Z, Kochman J, Filipiak KJ, Horszczaruk GJ, Grabowski M, Piatkowski R, et al. Mean platelet volume on admission predicts impaired reperfusion and long-term mortality in acute myocardial infarction treated with primary percutaneous coronary intervention. J Am Coll Cardiol. 2005;46(2):284-90.

Debili N, Masse JM, Katz A, Guichard J, Breton-Gorius J, Vainchenker W. Effects of the recombinant hematopoietic growth factors interleukin-3, interleukin-6, stem cell factor, and leukemia inhibitory factor on the megakaryocytic differentiation of CD34+ cells. Blood. 1993;82(1):84-95.

Saleh AU, Shah AA, Ali SS, Shah ST. Age and gender distribution in patients with acute ST elevation myocardial infarction; a survey in a tertiary care government hospital-NICVD, Karachi, Pakistan. The Internet J Cardiol. 2013;11(2):1-6.

Manchanda J, Potekar RM, Badiger S, Tiwari A. The study of platelet indices in acute coronary syndromes. Annals Pathol Labo Med. 2015 Jan 30;2(1):A30-5.

Vakili H, Kowsari R, Namazi MH, Motamedi MR, Safi M, Saadat H, et al. Could mean platelet volume predicts impaired reperfusion and in-hospital major adverse cardiovascular event in patients with primary percutaneous coronary intervention after ST-elevation myocardial in. The J Tehran University Heart Center. 2009;4(1):17-23.

Srivastava RK, Singh P, Puri A, Chaudhary G, Ali W, Verma A. Gender risk profile in acute myocardial infarction- a prospective study in Indian population. Int J Sci Res Pub. 2014;4(3):1-3.

Supel K, Salska A, Jaskiewicz F, Kacprzak M, Zielinska M. Mean platelet volume and its prognostic value in acute coronary syndrome complicated by cardiogenic shock. Cardiology J. 2013;20(3):254-60.

Ocak T, Erdem A, Duran A, Tekelioglu U, Ozturk S, Ayhan S, et al. The importance of the mean platelet volume in the diagnosis of supraventricular tachycardia. African Heal Sci. 2013;13(3):590-4.

Fabijanić D, Carević V, Bonacin D, Marković D, Pauković Sekulić BR, Sapunar A. Correlation between mean platelet volume and total risk of cardiovascular disease. Signa vitae: J Intesive Care Emerg Med. 2013 Oct 1;8(2):49-55.

Andronescu AM, Delcea C, Enache V, Stamate CS, Dorobantu M. Mean platelet volume variability in young patients with non-ST elevation acute myocardial infarction. J Med Life. 2014;7(3):107-13.

Mittal A, Agrawal BK, Manchanda B. Mean platelet volume in cases of acute myocardial infarction. The J Association Physicians India. 2016;64(1):74-5.

Ranjith MP, DivyaRaj R, Mathew D, George B, Krishnan MN. Mean platelet volume and cardiovascular outcomes in acute myocardial infarction. Heart Asia. 2016;8(1):16-20.