GIÁ TRỊ TIÊN LƯỢNG KẾT CỤC NỘI VIỆN CỦA TỈ SỐ THỂ TÍCH TIỂU CẦU TRUNG BÌNH/SỐ LƯỢNG TIỂU CẦU Ở BỆNH NHÂN NHỒI MÁU CƠ TIM CẤP

Abstract

Background: Platelet is a factor implicated in the pathogenesis of atherosclerotic plaque rupture and subsequent thrombosis, which significantly compromises plaque stability. This mechanism is closely associated with acute cardiovascular events, notably acute myocardial infarction (AMI). An increased in platelet volume is often correlated with increased synthesis of enzymatic factors, thereby promoting coagulopathy. These changes critically influence the efficacy of antiplatelet therapies and ultimately determine patient inpatient outcomes. Objective: This study aimed to determine the incidence of inpatient adverse cardiovascular events and to evaluate the prognostic utility of the mean platelet volume to platelet count ratio (MPV/PC) in patients diagnosed with acute myocardial infarction (AMI). Methods: A prospective study was conducted involving 183 patients who underwent percutaneous coronary intervention at the Interventional Cardiology Department of Nhân Dân Gia Định Hospital between March 2025 and September 2025. Comprehensive patients data, including anthropometric characteristics, hematological parameters (complete blood count, biochemical profile), clinical characteristics, and inpatient outcomes, were recorded. Statistical analysis employed Chi-square test, independent samples t-test, Mann-Whitney U test, univariate and multivariate logistic regression, and Receiver Operating Characteristic (ROC) curve analysis. Results: The observed incidence of inpatient adverse events among patients was 16,9%, with acute heart failure being the most prevalent complication. The area under the curve for the MPV/PC  ratio was 0,738. The derived optimal cutoff value was 0,032, yielding a sensitivity of 74,2%, a specificity of 67,8%, a positive predictive value of 31,9%, and a highly valuable negative predictive value of 92,8%. Multivariate analysis indicated that the ratio, left ventricular ejection fraction, and systolic blood pressure on admission were independent prognostic factors for inpatient adverse events. Conclusions: The overall rate of inpatient adverse events in the studied population was 16,9%. Factors significantly associated with these events included: age, history of diabetes mellitus, LVEF,  SBP on admission, creatinine levels, white blood cell count, platelet count, MPV and MPV/PC ratio. Crucially, the MPV/PC ratio, LVEF, and SBP upon hospital admission were confirmed as robust independent prognostic markers for predicting inpatient adverse outcomes.