The diagnostic predictive value of platelet count and platelet indices in patients with acute coronary syndrome: A comparative cross sectional study at TikurAnebesa Specialized Hospital, Addis Ababa, Ethiopia.

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Date

2023-09

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Addis Ababa University

Abstract

Background:Acute coronary syndrome(ACS) is the leading cause of death worldwide . The abnormality of Platelet and platelet indices are one of the most commonly identified hematological changes in ACS. Objective:To determine the diagnostic predictive value of platelet count and platelet indices in patients with ACS at TikurAnbesa Specialized Hospital, Addis Ababa, Ethiopia from April 2021-March2023. Methods:Hospital based comparative cross-sectional study was conducted among 76 ACS patients of cases and 152 controls (apparently healthy individuals) in TikurAnbesa specialized hospital(TASH)in Addis Ababa conducted from April 2021 to March 2023. Convenient sampling technique was used. Independent t testwas used for comparison betweenthe twogroups.ROC(receiver operating characteristic) curve test used to calculate positive and negative predictive values, sensitivity and specificity for a given platelet indices. Data was entered and analyzed using SPSS version 25 and level of significance was determined when P value was < 0.05. Result:The mean age of ACS group(50.91±11.33) and control group (51.85±11.7) was matched. Males study participants predominated females in all groups.The mean of Mean Platelet Volume(MPV) (11.66±.1.19)fl, Platelet Large Cell Ratio(PLCR) (37.35 ± 9.58)% and Platelet Distribution Width(PDW) (15.10 ±3.53)fl of ACS group was significantly higher than the control group (10.17±1.24)fl, (26.55 ±11.20)%,(11.52 ±2.88)fl, respectively with (p value <0.001) . In Roc analysis MPV ,PDW, PLCR had cut off value of >10.9fl, >12.7fl, >33.2%, value, respectively and can differentiate ACS from healthy individuals with Sensitivity of 84.2%,78.9%76.3%, Specificity of 75%,67.1%74.3%,Postive Predictive value(PPV)of 66%,54.1%,61.1% and Negative predictive value (NPV) of 90.4%,86.3%,86.3% ,respectively. The Area under Curve (AUC) of MPV, PDW and PLCR was 0.788, 0.767 and 0.746. Conclusion: The mean ofMPV, PDW and PLCR were significantly increased in ACS compared to control group value .MPV has the highest value of sensitivity, specificity, NPV and PPV followed by PLCR then PDW. These parameters could be used as a supportive tool for prediction of ACS disease on the top of the clinical diagnosis and advanced tests set up.

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Keywords

Acute Coronary syndrome, Platelet count and indices, Diagnostic predictivevalue

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