Association Between Platelet Volume Indices and ST-Segment Elevation Myocardial Infarction (STEMI)

Background: Platelet volume indices particularly mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (PLCR) reflect platelet activation and have emerged as promising biomarkers in ST-segment elevation myocardial infarction (STEMI). Elevated platelet size parameters are associated with increased thrombotic activity, impaired re-perfusion, and worse clinical outcomes in STEMI. Objective: This study aimed to evaluate the association between platelet volume indices and STEMI among patients admitted to a tertiary care hospital in Bangladesh. Methods: A prospective observational cross-sectional study was conducted at the Department of Cardiology, Shaheed Ziaur Rahman Medical College Hospital, Bogra, enrolling 100 participants (50 STEMI patients and 50 age- and sex-matched healthy controls). Platelet indices, including MPV, PDW, and PLCR, were measured using an automated hematology analyzer. Statistical analysis was performed using the Mann–Whitney U test, with p < 0.05 considered significant. Results: The mean platelet count was higher in STEMI cases than in controls (3.52 ± 0.78 vs. 3.26 ± 0.82 lac/mm³), though not statistically significant (p = 0.099). However, MPV, PDW, and PLCR were significantly elevated in STEMI patients compared to controls—MPV (10.27 ± 1.60 vs. 8.17 ± 1.30 fL, p < 0.001), PDW (15.75 ± 2.42 vs. 12.99 ± 2.45%, p < 0.001), and PLCR (31.94 ± 13.32 vs. 22.02 ± 8.79%, p < 0.001). Conclusion: Platelet size and activation markers MPV, PDW, and PLCR were significantly increased in STEMI patients, indicating enhanced platelet reactivity and thrombogenic potential. In contrast, total platelet count alone was not associated with STEMI. These findings underscore the value of platelet volume indices as accessible, low-cost tools for assessing thrombotic risk and predicting outcomes in STEMI patients.