Association Between Emergency Department Mean Platelet Volume and Angiographic Severity in Unstable Angina: A Prognostic Study

Objective Mean platelet volume (MPV) has been associated with thrombotic risk and acute coronary syndrome (ACS) severity in various clinical settings. However, data regarding its prognostic value in unstable angina (UA) patients presenting to the emergency department (ED) are limited. This study aimed to investigate the relationship between MPV measured at ED admission and the angiographic severity of ACS, as quantified by the Gensini score, in patients with UA. A secondary objective was to assess the predictive value of MPV for all-cause mortality. Material and Method This retrospective cohort study included 203 patients diagnosed with ACS between July 2022 and July 2023. MPV and other laboratory parameters were recorded at the time of admission. Coronary angiography findings were evaluated using the Gensini scoring system. Data were analyzed based on Gensini score categories and mortality status. Results MPV values were significantly higher in patients with high Gensini scores and in those who experienced mortality (p <0.001). In patients with UA, MPV demonstrated good predictive value for identifying high Gensini scores (AUC: 0.807, p = 0.006). MPV, age, and troponin were associated with angiographic severity, while MPV, neutrophil-to-lymphocyte ratio (NLR), and Gensini score were independently associated with mortality. In the overall cohort, MPV remained a strong predictor of mortality (AUC = 0.777, p <0.001). Multivariate analysis revealed that MPV (OR: 4.503; 95% CI: 1.233–16.443; p = 0.023) and NLR (OR: 1.826; 95% CI: 1.164–2.864; p = 0.009) were independent predictors of mortality in patients with UA. Conclusion MPV measured at the time of ED presentation inde- pendently predicts angiographic severity and short- term mortality in patients with unstable angina, un- derscoring its potential utility for early risk stratification and management decisions.