To assess the diagnostic and prognostic significance of MPV and SIRI in patients presenting with acute coronary syndrome.(STEMI/NSTEMI/UN STABLE ANGINA)

Acute coronary syndrome (ACS), which includes unstable angina, non-ST elevation myocardial infarction (NSTEMI), and ST elevation myocardial infarction (STEMI), is a leading cause of hospitalization and death globally【1】. The pathophysiology of ACS involves plaque rupture, platelet activation, thrombus formation, and a significant inflammatory component【2】. Early diagnosis and accurate risk stratification are critical for improving patient outcomes and guiding therapy.

Mean Platelet Volume (MPV) is a simple, cost-effective parameter obtained from the complete blood count. It reflects platelet size and activity-larger platelets are more reactive and thrombogenic. Studies have demonstrated that MPV is elevated in patients with ACS and may correlate with infarct size and poor prognosis【3,4】.

The systemic inflammatory response plays a pivotal role in the destabilization of atherosclerotic plaques. Recently, novel inflammatory indices such as the Systemic Inflammatory Response Index (SIRI)-calculated as (neutrophil count × monocyte count) / lymphocyte count-have emerged as potential marker for cardiovascular risk. SIRI reflects the combined effect of pro-inflammatory and anti-inflammatory components of the immune system【5】. Elevated SIRI has been associated with adverse outcomes in various conditions, including stroke, cancer, and cardiovascular diseases【6,7】.

Despite the individual significance of MPV and SIRI, limited data are available on their combined utility in ACS patients. Evaluating both markers together may provide a more comprehensive picture of the thrombo-inflammatory state and help identify high-risk patients at admission, facilitating more personalized care【8】.

Inclusion Criteria:

• Patients ≥ 18 years old.

  • Diagnosed with acute coronary syndrome (unstable angina, NSTEMI, STEMI).
  • Admission within 24 hours of symptom onset.

Exclusion Criteria:

• o Active infection or chronic inflammatory diseases.

  • Known hematological disorders or malignancy.
  • Chronic liver or renal failure.
  • Recent surgery or trauma (< 1 month).
  • Patients with rheumatic heart disease
  • Patient refusal

Acute coronary syndrome (ACS), which includes unstable angina, non-ST elevation myocardial infarction (NSTEMI), and ST elevation myocardial infarction (STEMI), is a leading cause of hospitalization and death globally【1】. The pathophysiology of ACS involves plaque rupture, platelet activation, thrombus formation, and a significant inflammatory component【2】. Early diagnosis and accurate risk stratification are critical for improving patient outcomes and guiding therapy.

Mean Platelet Volume (MPV) is a simple, cost-effective parameter obtained from the complete blood count. It reflects platelet size and activity-larger platelets are more reactive and thrombogenic. Studies have demonstrated that MPV is elevated in patients with ACS and may correlate with infarct size and poor prognosis【3,4】.

The systemic inflammatory response plays a pivotal role in the destabilization of atherosclerotic plaques. Recently, novel inflammatory indices such as the Systemic Inflammatory Response Index (SIRI)-