Mean Platelet Volume as a Predictor of Myocardial Infarction Risk: Association with Hypertension, Smoking, Diabetes Mellitus, and Alcohol Consumption in STEMI and NSTEMI Patients — A Cross-Sectional Study

Background: Cardiovascular diseases remain the foremost cause of mortality globally, with acute myocardial infarction (AMI) constituting a major proportion. Mean platelet volume (MPV), a marker of platelet size and reactivity, has been proposed as a cost-effective predictor of thrombotic cardiovascular events. However, its association with conventional cardiovascular risk factors in the context of ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) remains insufficiently characterized. Methods: This hospital-based cross-sectional study was conducted over a period of one year at a tertiary care centre. A total of 60 patients diagnosed with AMI (30 STEMI and 30 NSTEMI) and 60 age- and sex-matched healthy controls were enrolled. Venous blood samples were collected within six hours of admission into EDTA tubes for estimation of platelet count, MPV, platelet distribution width (PDW), and plateletcrit (PCT) using an automated hematology analyzer. Conventional risk factors including hypertension, diabetes mellitus, smoking, and alcohol consumption were documented. Statistical analysis was performed using SPSS version 26.0, employing Chi-square test, Student’s t-test, and ANOVA, with significance set at p<0.05. Results: Mean MPV was significantly elevated in AMI cases (10.58±0.91 fL) compared to controls (8.49±0.87 fL, p<0.001). STEMI patients demonstrated a higher mean MPV (10.97±0.82 fL) than NSTEMI patients (10.19±0.88 fL, p=0.001). Among hypertensive AMI cases, 38.46% of STEMI patients had MPV >11 fL compared to 8.33% in NSTEMI (p<0.001). Smokers with STEMI showed significantly higher MPV values than non-smokers and controls (p=0.002). Diabetic patients in the STEMI group had a higher prevalence of elevated MPV (p=0.014). Alcohol consumption was not significantly associated with MPV elevation (p=0.29). Conclusion: MPV was significantly elevated in patients with AMI, particularly in the STEMI subgroup. A synergistic association was observed between elevated MPV and traditional cardiovascular risk factors, especially hypertension, smoking, and diabetes mellitus. MPV may serve as a simple, inexpensive, and readily available biomarker for early cardiovascular risk stratification.