Platelets, February 2008; 19(1): 80–81

LETTER TO THE EDITOR

Mean platelet volume does not predict risk of myocardial infarction orcoronary artery disease in Indian patients

SHARAT DAMODAR, KALYAN VARA GANESH, & SREEDHAR MURTHY

Dept of Haematology, Narayana Hrudayalaya, Bangalore, India

To the Editor

Myocardial infarction (MI) and coronary artery

disease (CAD) is a significant cause for morbidity

and mortality even in developing countries like India.

Significant risk factors such as diabetes, hyperten-

sion, smoking, hypercholesterolemia and lifestyle

have been already studied. Mean platelet volume

(MPV) has been found to be an independent risk

factor in western populations and also from Indian

Data [1–3]. Hence we thought it appropriate to look

at this parameter in Indian patients with history of

MI or CAD.

This study was a prospective cross sectional study.

Five hundred consecutive patients, admitted to the

Department of Cardiology, were screened of which

170 fulfilled criteria for myocardial infarction and

77 patients fulfilled criteria for CAD. The study was

approved by the Hospital Ethics Committee and all

patients gave informed consent. The first group had a

history of MI as per the World Health Organization

(WHO) criteria or presented with MI. The second

group includes patients with stable CAD without

prior unstable angina or MI. Data on history of

diabetes mellitus and hypertension was also

collected.

EDTA blood samples were drawn at admission

after consent and samples were analysed on the LH

500 (Beckman Coulter, Bangalore, India). All

samples were analysed within 2 hours of collection.

Two hundred and forty seven patients were

included in this study. The ages ranged from 40–81

years. There were 210 males (85%). The first group

with MI had 170 patients and the second group with

CAD had 77 patients. The demographic data

is shown in Table I.

From this data we see that only about 8.8% of

patients with MI and 9% of patients with CAD had

an MPV value greater than 10. From earlier studies

such as by Endler et al. [1], we see that higher cut-off

such as 11.6 have been used and this has been shown

to be an independent risk factor. However in our

observation we find that a very small number of

patients had MPV values more than 11. Our data is

again at variance from the data published by

Khandekar et al. [2], where 210 Indian patients

were studied. They concluded that larger platelets

are haemostatically more active and are a risk factor

for developing coronary thrombosis, leading to

myocardial infarction. Patients with larger platelets

can easily be identified during routine haematologi-

cal analysis and could possibly benefit from

preventive treatment. Kilicli et al. [3] have studied

200 patients in Turkey and also noted that high MPV

is an independent risk factor for coronary athero-

sclerosis and MI. We however do not seem to agree

with these studies and suggest that a larger cohort of

patients be studied in India, and only then give

significance to platelet indices.

Table I. Demographic data.

MI (170) CAD (77)

Male patients (%) 145 (85%) 65 (84%)

Median age, years 55.8 (40–77) 58 (43–81)

Diabetes (%) 97 (57%) 53 (68%)

Hypertension (%) 98 (57%) 51 (66%)

Mean MPV, range 8.678 (7–11.4) 8.68 (7–11.8)

MPV410 (%) 15 (8.8%) 7 (9%)

MPV49 (%) 55 (32.3%) 25 (32.4%)

Mean platelet count 291.4 285.6

Correspondence: Sharat Damodar, Dept of Haematology, Narayana Hrudayalaya, Bangalore, India. E-mail: drsharat.damodar@gmail.com

ISSN 0953–7104 print/ISSN 1369–1635 online � 2008 Informa UK Ltd.

DOI: 10.1080/09537100701658206

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References

1. Endler G, Klimesch A, Sunder-Plassman H, Schillinger M,

Exner M, Mannhalter C, Jordanova N, Christ G,

Thalhammer R, Huber K et al. Mean platelet volume is

an independent risk factor for myocardial infarction but not

for coronary artery disease. Br J Haematol 2002;117:

399–404.

2. 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;59:146–149.

3. Kilicli-Camur N, Demirtunc R, Konuralp C, Eskiser A,

Bas� aran Y. Could mean platelet volume be a predictive

marker for acute myocardial infarction?. Med Sci Monit

2005;11:387–392.

Mean platelet volume does not predict risk of MI or CAD in Indian patients 81

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