International Journal of Cardiovascular Sciences. 25/fev/2025;38:e20240055.

Platelet Distribution Width as a Marker for Severity and Extent of Coronary Artery Disease in Acute Coronary Syndrome

Fuat Polat , Zeynettin Kaya , Atakan Yanikoğlu

DOI: 10.36660/ijcs.20240055

Este Artigo Original é referido pelo Editorial "Platelet Distribution Width: A New Prognostic Marker for Patients with Acute Coronary Syndrome?".

Abstract

Background

Previous studies have demonstrated an association between larger platelet volume and coronary thrombus formation in acute coronary syndrome (ACS).

Objectives

We aimed to investigate the association of platelet distribution width (PDW) levels with both the clinical severity and the extent of coronary artery disease (CAD) in patients diagnosed with ACS.

Methods

A retrospective evaluation was conducted on 1043 consecutive patients diagnosed with ACS. Patients were stratified into two groups based on their PDW values: group 1 (PDW > 11.8 fL) and group 2 (PDW ≤ 11.8 fL). For each patient, Global Registry of Acute Coronary Events (GRACE) score, SYNTAX score, Thrombolysis in Myocardial Infarction (TIMI) flow grade, thrombus grades of culprit lesions, and neutrophil–lymphocyte ratio (NLR) were calculated, and their associations with PDW were examined.

Results

The mean age of the patients was 60.1 ± 12.4 years, with the majority being male (78.5%). The mean PDW was 11.8 fL (range: 8.9 to 22.0). Patients in group 1 exhibited higher NLR (3.21 versus 2.13, p < 0.05) and higher GRACE scores (139 versus 126, p < 0.05) compared to group 2. Group 1 patients also showed lower TIMI flow grades (0 and 1). A positive correlation was observed between PDW and GRACE score (R: 0.304, p = 0.01), but not with the SYNTAX score.

Conclusion

Elevated PDW levels in patients with ACS were associated with more severe disease, as indicated by higher GRACE scores and reduced TIMI flow grades.