Mean Platelet Volume Ratio Research Articles

Predictive Value of Hematological Parameters in Non-ST Segment Elevation Myocardial Infarction and Their Relationship with the TIMI Risk Score

ABSTRACT Background: Hematological parameters, such as white blood cell count (WBC), mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and WBC to MPV ratio (WMR), could provide data in prognosis, risk stratification, and optimal management in patients with acute coronary syndromes. Aim: We aimed to investigate the prognostic value of hematological parameters and their relationship with the TIMI risk score in non-ST elevation myocardial infarction (NSTEMI) patients. Material and Methods: A total of 259 adult patients with NSTEMI were included in this retrospective and observational cohort study. During a 1-year follow-up period, the efficacy of the main hematological parameters in predicting major adverse cardiovascular events (MACE) and their correlation with the TIMI risk score was analyzed. Results: Among the 259 patients, 188 (72.6%) were male, and the mean age was 60.4 ± 11.9 years. MACE was observed in 60 patients (23.2%). Elevated baseline levels of WBC, neutrophils, NLR, PLR, and WMR were associated with MACE development throughout the 1-year follow-up. Moreover, WBC, WMR, and NLR were correlated with the TIMI risk score. When the predictive power of these parameters for MACE was evaluated by ROC analysis, the AUC values for WBC, WMR, and NLR were 0.670 (95% CI 0.590–0.750), 0.666 (95% CI 0.582–0.746), and 0.689 (95% CI 0.610–0.767), respectively. Conclusion: WBC, NLR, and WMR predicted MACE in NSTEMI patients and were consistent with the TIMI risk score. On this basis, they could provide supportive data for early risk stratification and optimized therapeutic approach, particularly in high-risk patients.

Role of platelet indices in prediction of preeclampsia.

To compare platelet indices in preeclamptic and normotensive pregnants and to investigate the clinical use of these parameters in preeclampsia prediction. This retrospective case- control study included 257 preeclampsia patients and 264 healthy pregnant women as the control group. The groups were compared in terms of platelet count (PC), mean platelet volume (MPV), platelet distribution range (PDW), plateletcrit (Pct), Pct / MPV ratio and PC / MPV ratio. Between the preeclampsia group and the control group; mean platelet count (227.22 ± 78.58 vs 236.69 ± 64.30), plateletcrit (PCT) (0.21 ± 0.06 vs 0.24 ± 0.27), and platelet distribution width (PDW) (17.11 ± 0.80 vs 17.29 ± 0.82) were not significantly different (p> 0.05). However, MPV values were significantly higher in the preclampsia group compared to the control group (9.66 ± 1.62 and 8.92 ± 1.33, respectively) (p < 0.001). In our study, the optimum cut-off value of MPV was 9.15 with 58.7% sensitivity and 61.7% specificity for the prediction of preeclampsia. Pct/MPV ratio (0.02 ± 0.007 vs 0.027 ± 0.029) ( p = 0.01) and PC/MPV ratio ( 24.63 ± 10.90 vs 27.63 ± 10.24) (p = 0.001) were significantly lower in the preeclampsia group than in the control group. In preeclampsia, changes in platelet functions, destruction and production lead to changes in platelet indices. Compared with normal healthy pregnant women, preeclamptic pregnant women have higher MPV values. In preeclampsia prediction, MPV and PC/MPV ratio are promising as a diagnostic parameter.

Koroner Aterosklerozda CagA Pozitif Helicobacter pylori Enfeksiyonu: Lenfosit Sayısının Ortalama Trombosit Hacmine Oranının Tanısal Değeri

Aim: Potent combined and long-term antithrombotic therapies that predispose to gastric injury are the mainstay of treatment in acute coronary syndromes (ACS). Severe chronic gastric mucosal inflammation due to the Helicobacter Pylori (H. pylori) infection was shown to be associated with higher peripheral blood lymphocytes and lower blood mean platelet volume (MPV) levels. We aimed to investigate the discriminative usefulness of blood lymphocyte to MPV ratio as a simple premise marker for CagA positive H. Pylori infection before the required advanced diagnostic tests in patients with coronary arterial disease (CAD). Materials and Methods: A total of 293 patients’ who had undergone elective and urgent coronary angiography due to CAD were included in the study. Serologic H. pylori infection status and hematological parameters were determined. Two groups were compared according to CagA serology status. Confounding factors were adjusted by propensity score matching and multivariate logistic regression analysis. Results: Rates of ACS, male gender, diabetes mellitus, family history of CAD, current smoking and lymphocyte to MPV ratio were higher in seropositive patients according to seronegative patients (p &amp;lt; 0.05). The ROC curve analysis showed that the lymphocyte to MPV ratio at a cut-off point of 165 had 71% sensitivity and 60% specificity for discriminating patients with positive H. pylori serology (AUC = 0.71, p &amp;lt; 0.0001). Lymphocyte to MPV ratio was independently associated with positive H. Pylori serology. Conclusion: Lymphocyte to MPV ratio can be helpful for discriminating CagA positive H pylori infected CAD patients requiring advanced confirmatory tests.

Diagnostic value of platelet associated biomarkers in chronic periprosthetic joint infection

Objective: To evaluate the diagnostic value of platelet count(PC),PC to mean platelet volume(MPV) ratio(PC/MPV) and plateletcrit(PCT) in chronic periprosthetic joint infection(PJI). Method: The medical records of 159 patients who underwent hip or knee revisions at Department of Joint Surgery,Affiliated Hospital of Qingdao University from August 2013 to June 2019 were retrospectively reviewed. There were 51 patients(26 knees and 25 hips) in the PJI group,which included 28 males and 23 females,aged (68.0±11.8)years (range:32 to 84 years)with a body mass index(BMI)of (26.1±3.6) kg/m².There were 116 patients(19 knees and 97 hips) in the aseptic loosening(AL) group,including 67 males and 49 females,aged (70.3±8.9)years(range:49 to 89 years)with a BMI of (25.0±3.6)kg/m².The plasma C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),PC,MPV,PC/MPV and PCT levels of the two groups were recorded and analyzed. Receiver operating characteristic curve was used to calculate the sensitivity and specificity of each biomarker,expect for MPV,and the diagnostic value of each biomarker was compared according to the area under the curve(AUC).Independent-sample t test or Mann-Whitney U test were used for comparison between groups. Result: Compared with AL group,AJI group had significantly higher levels of CRP,ESR,PC,PC/MPV and PCT(all P<0.05),but lower level of MPV (P<0.05).The AUCs for CRP,ESR,PC,PC/MPV and PCT were 0.820, 0.829, 0.689, 0.668 and 0.676,respectively. Based on the Youden index,the optimal predictive cutoff for CRP was 11.12 mg/L,with a sensitivity of 74.4% and a specificity of 87.1%.The optimal predictive cutoff for ESR was 17.60 mm/1 h,with a sensitivity of 81.4% and a specificity of 75.3%.The optimal predictive cutoff for PC was 243.00×109/L,with a sensitivity of 60.6% and a specificity of 71.8%.The optimal predictive cutoff for PC/MPV was 24.95,the sensitivity was 58.1% and the specificity was 74.1%.And the optimal predictive cutoff for PCT was 0.24%,with a sensitivity of 69.8% and a specificity of 63.5%. Conclusion: PC,PC to MPV ratio and PCT were of limited value to diagnose PJI.

Serum Inflammatory Biomarkers in the Diagnosis of Periprosthetic Joint Infections

Accurate preoperative diagnosis of periprosthetic joint infections (PJIs) can be very challenging, especially in patients with chronic PJI caused by low-virulence microorganisms. Serum parameters, such as serum C-reactive protein (CRP) or the erythrocyte sedimentation rate (ESR), are—among other diagnostic test methods—widely used to distinguish septic from aseptic failure after total hip or knee arthroplasty and are recommended by the AAOS in the preoperative setting. However, they are systemic parameters, and therefore, unspecific. Nevertheless, they may be the first and occasionally the only preoperative indication, especially when clinical symptoms are lacking. They are easy to obtain, cheap, and are available worldwide. In the last decade, different novel serum biomarkers (percentage of neutrophils, neutrophils to lymphocytes ratio, platelet count to mean platelet volume ratio, fibrinogen, D-Dimer, Il-6, PCT) were investigated to find a more specific and accurate serum parameter in the diagnosis of PJI. This article reviews the diagnostic value of established (serum CRP, ESR, WBC) and ‘novel’ serum inflammatory biomarkers (fibrinogen, D-dimer, interleukin-6 (IL-6), procalcitonin, percentage of neutrophils (%N), neutrophils to lymphocytes ratio (NLR), platelet count to mean platelet volume ratio (PC/mPV)) for the preoperative diagnosis of periprosthetic joint infections.

Evaluation of CBC Parameters in Relation to PCR Test Results in Diagnosing Pediatric COVID-19 Disease

AbstractObjective This study aimed to investigate whether complete blood count parameters have predictive properties in diagnosing coronavirus disease 2019 (COVID-19) in regard to positive polymerase chain reaction (PCR) test in children with a prediagnosis of COVID-19, and whether these parameters are related to the severity of clinical findings in children with COVID-19.Methods This retrospective cross-sectional study included children who were hospitalized with a possible diagnosis of COVID-19 and had undergone PCR testing in the COVID-19 children's clinic. Probable case definition was made according to the COVID-19 diagnostic and therapeutic guidelines of the Ministry of Health of the Republic of Turkey.Results A total of 133 patients were included in the study, of which 46 (34.6%) were negative for the PCR test and 87 (65.4%) were positive for the PCR test. white blood cell (WBC), neutrophil, lymphocyte, and platelet levels were significantly lower in the PCR positive group than in the PCR negative group. The platelet to mean platelet volume ratio (PLT/MPV) was significantly lower in the PCR positive group than the PCR negative group, whereas the platelet distribution width (PDW) of the PCR positive patient group was significantly higher than the PCR negative group. For the multivariable model with PDW and neutrophil to lymphocyte ratio/age factors included, F1 score was 0.864, area under the receiver operating characteristics was 0.804, and area under the precision-recall curve was 0.873. The decision tree had a 72.9% cross-validation accuracy value.Conclusion WBC, neutrophils, lymphocytes, platelets, PLT/MPV, and PDW parameters could be used in conjunction with clinical symptoms and findings to predict the PCR test result.

Hemostatic system changes among diabetic foot ulcer patients

Background There are many reports about hemostatic changes in patients with diabetic foot ulcer (DFU). There are some reports about changes in the platelet morphology in patients with DFU. The goal of this research was to see whether platelet indices and hemostatic status might be used as predictors of DFU. Aim We aimed to assess the changes in the hemostatic system (hemostatic state and platelet indices) among patients with DFU. Patients and methods A total of 80 individuals were included in the study. They were divided into three groups: group 1 represented 20 diabetic patients without diabetic ulcer, group 2 represented 40 patients with known DFU, group 3 represented 20 normal healthy individuals. Laboratory investigations included fasting blood glucose level, kidney function tests (urea and creatinine), glycosylated hemoglobin, complete blood count including platelet count and platelet indices (platelet distribution width, mean platelet volume, plateletcrit, and platelet larger cell ratio), prothrombin time, international normalized ratio, activated partial thromboplastin time, and FVIII. Results Platelet indices (platelet distribution width, mean platelet volume, plateletcrit, and platelet larger cell ratio) were significantly greater in patients with DFU compared with other groups (P=0.0001), and FVIII was also significantly higher in patients with DFU compared with other groups (P=0.0001). Conclusion Diabetes is linked to a prothrombotic propensity as well as a hypercoagulable condition. Platelet indices indicate that patients with DFU have extra-reactive and aggregable platelets. Platelet indices could be used as an easy and cheap method for prediction and progression of DFU.

May red cell distribution width (RDW)/mean platelet volume (MPV) ratio be a diagnostic parameter in extrahepatic cholestasis due to biliary stones?

May red cell distribution width (RDW)/mean platelet volume (MPV) ratio be a diagnostic parameter in extrahepatic cholestasis due to biliary stones?

Globulin, the albumin-to-globulin ratio, and fibrinogen perform well in the diagnosis of Periprosthetic joint infection

BackgroundAlthough periprosthetic joint infection (PJI) is a severe complication of total joint arthroplasty (TJA), the diagnosis of PJI remains challenging. Albumin (ALB), globulin (GLB), the albumin-to-globulin ratio (AGR), and fibrinogen could be indicators of the body’s inflammatory state. This study aimed to compare the diagnostic accuracy of these biomarkers with that of other inflammatory biomarkers in PJI patients.MethodsWe conducted a retrospective cohort study that included a consecutive series of patients undergoing debridement antibiotic irrigation and implant retention (DAIR), one-stage or the first stage of a two-stage revision total knee arthroplasty (TKA) or total hip arthroplasty (THA) for acute (n = 31) or chronic (n = 51) PJI, or revision TKA or THA for aseptic failures (n = 139) between January 2017 and December 2019 in our hospital. The 2013 criteria of the Musculoskeletal Infection Society (2013 MSIS) were used as the reference standard for the diagnosis of PJI. The preoperative ALB, GLB, AGR, fibrinogen, D-dimer, platelet count, fibrin degradation product (FDP), platelet-to-lymphocyte (PLR), platelet count to mean platelet volume ratio (PVR), neutrophil-to-lymphocyte ratio (NLR), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were assessed. The receiver operating characteristic curve (ROC), sensitivity, and specificity were utilized to compare different biomarkers.ResultsCompared with the aseptic patients, the GLB, D-dimer, fibrinogen, FDP, platelet count, PVR, PLR, NLR, ESR, and CRP levels of PJI patients were significantly higher (P < 0.01); however, the ALB and AGR levels were significantly lower (P < 0.01). The area under the curve (AUC), sensitivity and specificity were 0.774, 67.50, 77.54% for ALB; 0.820, 57.50, 89.86% for GLB; 0.845, 66.25, 93.48% for AGR; 0.832, 78.48, 78.95% for fibrinogen; 0.877, 81.48, 85.07% for ESR; 0.909, 83.95, 88.89% for CRP; 0.683, 55.22, 75.83% for D-dimer; 0.664, 38.81, 88.33% for FDP; 0.678, 52.44, 79.86% for platelet count; 0.707, 48.78, 86.33% for PVR; 0.700, 51.22, 80.58% for PLR; and 0.678, 52.44, 81.30% for NLR, respectively. In the clinic, GLB, AGR and fibrinogen could be used for diagnosis of patients suspected of having PJI.ConclusionOur study demonstrated that GLB, AGR, and fibrinogen were promising biomarkers in the diagnosis of PJI.

The role of the platelet profile in the prediction of gestational diabetes

Objective: In our study, the results of oral glucose tolerance test (OGTT) and other hemogram parameters of pregnant women with and without gestational diabetes mellitus (GDM) were compared. The aim of our study is to investigate the benefit of these parameters in predicting GDM risk. Material and Method: The study was planned as a descriptive, retrospective and cross-sectional study. It was included 218 pregnant women who applied to the Gynecology and Obstetrics Clinic of Amasya Sabuncuoğlu Şerefeddin Training and Research Hospital between January 01, 2019 and January 31, 2020. It was examined complete blood count parameters, ultrasound findings, complete urinalysis, first trimester blood glucose, body mass index, age, and gravide parameters the patients we included in the study. The results were analyzed retrospectively and was evaluated the statistical significance relationship with gestational diabetes. Results: There was no statistically significant difference in age, body mass index (BMI), obesity status and number of gravida between the pregnant women who were examined and those without GDM (p&gt; 0.05). The hemoglobin, platelet count, mean platelet volume (MPV), mean corpuscular volume (MCV), mean corpuscular hemoglobine (MCH), and mean corpuscular hemoglobin concentration (MCHC) values, and neutrophil, lymphocyte, monocyte and basophil counts, urine density and femur length were statistically significant. There was no difference (p&gt; 0.05). No statistically significant difference was found in terms of neutrophile lymphocyte ratio (NLR), neutrophile monocyte ratio (NMR), platelet lymphocyte ratio (PLR), monocyte eosinophil ratio (MER), platelet MPV ratio (PMPVR), and platelet neutrophile ratio (PNR) values (p&gt; 0.05) Conclusion: HbA1c, hematocrit and blood glucose in the first trimester may be predictors of GDM. In addition, we think that further studies are needed in a prospective design in more patients in terms of others parameters.

Do complete blood count parameters predict diagnosis and disease severity in obstructive sleep apnea syndrome?

Inflammation and platelet activation play a role in the pathogenesis of obstructive sleep apnea syndrome (OSAS). In this study, it was aimed to investigate the effectiveness of the systemic inflammation markers, the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and WMR (white blood cell count (WBC) to mean platelet volume (MPV) ratio), in determining the severity of OSAS. The study included 207 patients who visited the pulmonology polyclinic between 1 and 31 January 2020 with complaints of snoring, apnea periods during sleep and sleepiness and were assessed with polysomnography (PSG) with the indication of hospitalization. The patients were grouped based on their apnea-hypopnea index (AHI) scores as 54 patients with AHI<5 as the control group, 41 patients with AHI=5-15 as the mild, 54 patients with AHI=15-30 as the moderate and 58 patients with AHI>30 as the severe OSAS groups. From the complete blood counts of the patients, NLR, PLR and WMR were calculated. The demographic characteristics of the patient and control groups were assessed by comparing PSG and blood parameters. The mean age of the 207 patients included in the study was 54.56±10.24 years. Among the patients, 58.5% were male, and 41.5% were female. Between the control and OSAS groups, there were significant differences in terms of the WBC and lymphocyte counts (p=0.004 and p=0.035). In terms of the NLR and PLR values, there was no significant difference among the OSAS groups (p=0.723 and p=0.309). WMR had a significant difference in the OSAS groups (p=0.001). It was determined that WMR was valuable especially in distinguishing severe OSAS from the other groups. In our study, where OSAS severity and complete blood count parameters assessed as inflammatory markers were examined, it was identified that the NLR and PLR levels were not very determinant in predicting either OSAS or its severity, and among these parameters, WMR was more significant, and it was determinant in distinguishing severe OSAS. Therefore, we believe it is needed to plan new studies without losing time over these markers in the diagnosis of OSAS, determination of its severity and its monitoring.

Faible valeur du rapport nombre de plaquettes sur le volume plaquettaire moyen pour les diagnostics des infections péri-prothétiques : étude cas témoin

IntroductionNumerous tests are being evaluated in order to aid the diagnosis of periprosthetic infections since it is a complicated and sometimes inconclusive process. The purpose of this study was to assess the diagnostic performance of platelet count to mean platelet volume ratio as a tool to aid the diagnosis of periprosthetic joint infections. The investigated questions were: “Is platelet count/mean platelet volume ratio more sensitive or specific than C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) in the diagnosis of periprosthetic joint infections?” and “Does platelet count/mean platelet volume ratio increase the accuracy of periprosthetic joint infection diagnosis?”. HypothesisPlatelet count/mean platelet volume ratio increases the accuracy of periprosthetic joint infection diagnosis. Materials and methodsThis study was performed retrospectively on patients who underwent revision hip or knee arthroplasty between 2016 and 2019. 62 patients with 33 aseptic (AR) and 29 septic revision (SR) who met our inclusion criteria were included. The sensitivity, specificity and diagnostic performance of CRP, ESR and platelet count/mean platelet volume values were analyzed and compared. ResultsThe demographic characteristics were similar between groups. Staphylococcus aureus and Staphylococcus epidermidis were the most commonly encountered microorganisms, while seven patients had negative cultures in SR group. ESR, CRP and platelet count/mean platelet volume values were significantly higher in SR group compared to AR group (p<0.01). ROC analysis for platelet count/mean platelet volume ratio revealed a cut-off value at 35.3 which provided 75.9 % sensitivity and 78.8 % specificity for periprosthetic joint infections. Platelet count/mean platelet volume ratio yielded lower sensitivity and similar specificity compared to ESR and CRP values. Platelet count/mean platelet volume had a lower area under curve value, indicating a poorer diagnostic performance compared to ESR and CRP. DiscussionThe diagnostic performance of platelet count/mean platelet volume ratio is low and current findings do not support its usage to increase the accuracy of periprosthetic joint infections diagnosis. Level of evidenceIII; diagnostic case-control study.

Morphological types of anaemia integrated with distribution of red cell and platelet indices: Study in a rural tertiary healthcare centre

Anaemia is a critical global health problemA good morphological subtyping of anaemia can guide clinician in further patient management. With the advent of automation, red cell and platelet indices are available from the routinely used blood cell counters in the laboratory, these supplemented with peripheral smear examination help in a good categorization of anaemia. Aim of this study is to study the morphological types of anaemias in the adults with the Objectives of Categorization of the anaemias based on morphology and to study the distribution of the red cell and platelet indices in the same.: It was a prospective study conducted in the hematology wing of our central diagnostics over a period of three months and a total of 520 cases, which were morphologically classified according to the analyzer indices and peripheral smear. Distribution of the red cell and platelet indices in the different categories of anaemia were also noted. A majority of the anaemias were microcytic hypochromic in type (67.1%) followed by normocytic normochromic anaemias (26.5%). Increased RDW was seen in microcytic hypochromic anaemias (55%) and normocytic normochromic anaemias (6.9%). The Mean platelet count/ mean platelet volume was increased in microcytic anaemias compared to others. : Anaemias in the rural set up are predominantly of the microcytic in type. A good knowledge of the variation in RBC indices, RDW and platelet /mean platelet volume ratio along with a peripheral smear can help the reporting haematologist identify early stages of iron deficiency anaemia and can give a precise and accurate anaemia categorization at the basic entry level of laboratory investigation. Interpretation of variation in RBC and platelet indices though often neglected can contribute significantly to categorize the anaemia.

RELATIONSHIP BETWEEN RED BLOOD CELL AND PLATELET INDICES IN IRON DEFICIENCY ANEMIA

Objective: To find out the correlation between the red blood cell and platelet indices in patients presenting with iron deficiency anemia at a tertiary care hospital of Pakistan.&#x0D; Study Design: Cross-sectional study.&#x0D; Place and Duration of Study: Department of Hematology, Combined Military Hospital Lahore, from Sep 2018 to Mar 2019.&#x0D; Methodology: The patients of age 1-70 years of either gender presenting with IDA were included in the study. The blood sample of patients were sent to laboratory to assess the red blood cell and platelet indices. SPSS-23 was used to analyze data.&#x0D; Results: Two hundred and seven patients fulfilling the inclusion criteria were included in this study. The mean age was 25.6 ±17.8years. Correlation was weak and insignificant between haemoglobin and packed cell volume (r=-0.385**, p&lt;0.01), haemoglobin and mean cell volume (r=-0.225**, p&lt;0.01), packed cell volume and mean cell haemoglobin (r =0.263**, p&lt;0.01), &amp; mean cell haemoglobin and mean platelet volume (r=0.143*, p&lt;0.05). Correlation was moderate and significant between platelet distribution width and mean platelet volume (r=0.511**) &amp; platelet distribution width and platelet large cell ratio (0.502**, p&lt;0.01). Correlation was strong between mean platelet volume and platelet large cell ratio (r=0.759**, p&lt;0.01).&#x0D; Conclusion: In conclusion, there was significant relation between red blood cell and platelets indices in iron deficiency anemia. Furthermore, haemoglobin and packed cell volume are weekly correlated, platelet distribution width and mean platelet volume are moderately correlated and mean platelet volume and platelet large cell ratio are strongly correlated.

Role of White blood Cell Count and Mean Platelet Volume ratio in Acute Coronary Syndrome patients: A short study

Abstract The white blood cell count to mean platelet volume ratio is an indicator of inflammation in patients with atherosclerotic disease. Acute coronary syndrome is a disease characterized in most of the cases by rupture of atherosclerotic plaque and subsequent complete or incomplete thrombosis of the coronary arteries.

Usefulness of WBC Count to Mean Platelet Volume Ratio in Predicting Short-Term (30 Days) Major Adverse Cardiac Events in Patients Presenting with Acute Coronary Syndrome and its Comparison in Males and Females

Abstract Background: Among cardiovascular illnesses, acute coronary syndrome (ACS) events are associated with higher mortality and morbidity. The mechanism of inflammation involved in the ACS includes atherosclerotic plaque development, followed by development of plaque rupture and thrombosis. The present study is to determine whether white blood cell count to mean platelet volume ratio (WMR) can predict short-term (30 days) major adverse cardiac events (MACE) in ACS patients, and also compare WMR and MACE in males and females. Aim: To detect usefulness of white blood cell (WBC) count to WMR in predicting short term (30 days) MACE in patients presenting with ACS and compare values and MACE events in males and females. Material and Methods: The present study was conducted in a tertiary-care hospital from September 2020 to December 2020. A total of 60 patients, who presented with ACS and were undergoing percutaneous coronary intervention (PCI), fulfilled the selection criterion; hence, a total of 60 patients were selected for the study after taking informed consent. The clearance from the Institutional Ethical committee (IEC) was obtained prior to the initiation of the study. All the necessary investigations were done in patients who fulfilled the inclusion criteria. The results of the study were systematically selected and analysis done statistically. The study included all patients with clinical suspicion of ACS for more than 18 years and excluded non-ACS patients, patients with malignancy history, inflammatory diseases, autoimmune disorders, infections, and those who are immunosuppressed. Results: In the present study, receiver operating characteristic (ROC) curve showed cutoff value of WMR as 1059 with area under curve (AUC) of 0.6 (95% CI 0.4–0.9). MACE occurred in 12 patients and mortality occurred in 6 patients. Among MACE, recurrent myocardial infarction (REMI) occurred in 7 (35%) cases, arrhythmias occurred in 5 (25%), and cardiogenic shock occurred in 8 (40%) cases. WMR with a cutoff value of 1059 was significant and highly accurate in predicting MACE, with sensitivity of 91.6%, specificity of 87.5%, PPV of 64.7%, NPV of 97.6%, and diagnostic accuracy of 88.3%. Compared to males, females have less sensitivity to, high specificity to, and high diagnostic accuracy of WMR ratio in predicting MACE. MACE did not show any gender predilection. Conclusion: In patients, who presented with ACS, high WMR values were associated with worse short-term outcomes and independently predicted short-term MACE. Compared to males, females have less sensitivity to, high specificity to, and high diagnostic accuracy of WMR ratio in predicting MACE.

Platelet Indices as Potential Monitoring Biomarkers in COVID-19: A New Hope

Objective: To investigate the relationship between established acute inflammatory markers in COVID-19 patients with Mean platelet volume (MPV) and Platelet large cell ratio (P-LCR).&#x0D; Materials and Methods: This was a retrospective longitudinal study conducted at Fauji Foundation Hospital, Rawalpindi from 10th June to 10th August 2020. Biochemical parameters i.e. CRP, serum ferritin, LDH, and pro-BNP as well as hematological parameters (MPV and P-LCR) were noted once every week during admission of all the COVID-19 positive patients.Data were analyzed using IBM-SPSS version 23. Repeated measure ANOVA using a generalized linear model was done to check the trend of values during the duration of their stay. Pearson Correlation analysis and regression models were estimated to check the relationship of MPV and P-LCR with C- reactive protein, serum Ferritin, LDH, and pro-BNP. P-values less than 0.05 were considered statistically significant.&#x0D; Results: The mean age of the studied group was 55.47 (SD=±15.0) years with the female to male ratio being 2:1. Mean platelet volume showed a statistically significant positive correlation with the established set of inflammatory markers other than pro-BNP with a p-value of less than 0.05.P-LCR however showed a positive correlation with CRP (p-value of less than 0.05) only with no significant correlation with other biochemical markers.&#x0D; Conclusion: MPV is reported on routine complete blood count report (CBC). It is readily available at even the most under-resourced health centers; therefore reporting the platelet indices does not require extra testing, sampling, or reagent cost. A statistically significant positive correlation amongst the established acute inflammatory markers and relatively understudied platelet indices (MPV) in COVID-19 provides a cost-effective, readily available, and time-efficient tool for marking disease progression.

Low value of platelet count to mean platelet volume ratio to diagnose chronic PJI: A case control study

IntroductionNumerous tests are being evaluated in order to aid the diagnosis of periprosthetic infections since it is a complicated and sometimes inconclusive process. The purpose of this study was to assess the diagnostic performance of platelet count to mean platelet volume ratio as a tool to aid the diagnosis of periprosthetic joint infections. The investigated questions were: “Is platelet count/mean platelet volume ratio more sensitive or specific than C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) in the diagnosis of periprosthetic joint infections?” and “Does platelet count/mean platelet volume ratio increase the accuracy of periprosthetic joint infection diagnosis?”. HypothesisPlatelet count/mean platelet volume ratio increases the accuracy of periprosthetic joint infection diagnosis. Materials and methodsThis study was performed retrospectively on patients who underwent revision hip or knee arthroplasty between 2016 and 2019. 62 patients with 33 aseptic (AR) and 29 septic revision (SR) who met our inclusion criteria were included. The sensitivity, specificity and diagnostic performance of CRP, ESR and platelet count/mean platelet volume values were analyzed and compared. ResultsThe demographic characteristics were similar between groups. Staphylococcus aureus and Staphylococcus epidermidis were the most commonly encountered microorganisms, while seven patients had negative cultures in SR group. ESR, CRP and platelet count/mean platelet volume values were significantly higher in SR group compared to AR group (p<0.01). ROC analysis for platelet count/mean platelet volume ratio revealed a cut-off value at 35.3 which provided 75.9% sensitivity and 78.8% specificity for periprosthetic joint infections. Platelet count/mean platelet volume ratio yielded lower sensitivity and similar specificity compared to ESR and CRP values. Platelet count/mean platelet volume had a lower area under curve value, indicating a poorer diagnostic performance compared to ESR and CRP. DiscussionThe diagnostic performance of platelet count/mean platelet volume ratio is low and current findings do not support its usage to increase the accuracy of periprosthetic joint infections diagnosis. Level of evidenceIII; diagnostic case-control study.

The role of platelet to mean platelet volume ratio in the identification of adult-onset still's disease from sepsis

OBJECTIVES:Inflammatory factors exert a significant role in the development of adult-onset Still’s disease (AOSD) and sepsis. Although platelet counts and platelet parameters have long served as indicators for inflammatory diseases, their role in the differential diagnosis between adult-onset stilĺs disease and sepsis remains unclear. We designed this retrospective study to explore whether the platelet to mean platelet volume (MPV) ratio (PMR) can help to distinguish AOSD from sepsis.METHODS:A total of 110 AOSD patients and 84 sepsis patients were enrolled in the study. Seventy-three AOSD patients and 56 sepsis patients between January 2010 and June 2017 were enrolled in the test cohort to analyze PMR values, which was then validated in the validation cohort (37 AOSD patients and 28 sepsis patients between June 2017 and December 2019).RESULTS:The values of PMR were significantly higher in AOSD patients than in sepsis patients (test cohort, validation cohort, and entire cohort), In the test cohort, logistic regression analysis showed that PMR was an independent risk factor of AOSD (odds ratios [OR]: 9.22, 95% confidence interval [CI] 2.15-39.46, p=0.003). Further receiver operating characteristic curve (ROC) analysis showed that the area under the ROC curve was 0.735 (95% CI 0.631-0.839, p<0.001) for PMR alone and 0.925 (95% CI 0.869-0.980, p<0.001) for the combination of PMR and serum ferritin. Consistently, the validation cohort exhibited analogous results.CONCLUSIONS:PMR could be used as a single indicator or a complementary indicator to distinguish AOSD from sepsis.

Biochemical predictors in presentations to the emergency department after a suicide attemp.

This study was conducted with an aim to determine whether biochemical parameters could be used to identify the individuals at risk of suicide. The experimental group consisted of a total of 46 patients that presented to the emergency department after a suicide attempt. 45 healthy individuals constituted the control group. All subjects were evaluated by using the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), and the Beck ScaleforSuicidal Ideation(BSSI). All subjects were evaluated for leukocyte count, mean platelet volume (MPV), C-reactive protein (CRP), cholesterol, triglyceride levels and neutrophil-lymphocyte ratio (NLR). The Vitamin D levels of the subjects in the experimental group were also measured. The BAI (p < 0.01), BDI (p < 0.01), and BSSI (p < 0.01) scores of the two groups were significantly different. The two groups were also significantly different in terms of CRP (p < 0.01), cholesterol (p < 0.05), NLR (p < 0.01), MPV (p < 0.01), triglyceride (p < 0.01) and leukocyte (p < 0.01) results. The vitamin D levels of the experimental group were found to be below normal vitamin D levels. High CRP levels were found to be a predictor of anxiety symptoms, and MPV and triglyceride levels were found to be predictors of depressive symptoms. We believe that biochemical parameters can be used to identify people with increased suicide risk, and suicide rates can be reduced by ensuring that these patients receive mental health care in the early period (Tab. 5, Ref. 42).