The aim of this study is to evaluate mean platelet volume (MPV) as a predictor of acute coronary syndrome (ACS) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD to evaluate mean platelet volume (MPV) as a predictor of acute coronary syndrome (ACS) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) in Sohag University Hospital.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern closely linked to metabolic syndrome, obesity, insulin resistance, and cardiovascular disease. Patients with MASLD have an increased risk of atherosclerosis and acute coronary syndrome (ACS), which remains a leading cause of morbidity and mortality worldwide. Early identification of patients at high cardiovascular risk is essential to improve outcomes.

Mean platelet volume (MPV) is an accessible and cost-effective hematological parameter that reflects platelet size and activity. Larger platelets are metabolically and enzymatically more active and have greater prothrombotic potential. Elevated MPV has been associated with increased platelet reactivity, endothelial dysfunction, and adverse cardiovascular events, including ACS. However, the predictive value of MPV for ACS in patients with MASLD has not been sufficiently investigated.

This study aims to evaluate MPV as a predictor of acute coronary syndrome in patients diagnosed with MASLD at Sohag University Hospital. By assessing the relationship between MPV levels and the occurrence of ACS, the study seeks to determine whether MPV can serve as a simple, noninvasive biomarker for cardiovascular risk stratification in this high-risk population.

The study will include patients with confirmed MASLD, who will undergo clinical evaluation, laboratory investigations including complete blood count for MPV measurement, and cardiovascular assessment. Participants will be categorized based on the presence or absence of ACS. Statistical analyses will be performed to evaluate the association between MPV and ACS and to determine its predictive value.

The findings of this study may contribute to improved risk assessment strategies and early identification of MASLD patients at increased risk for acute coronary events, potentially guiding preventive and therapeutic interventions.

Inclusion Criteria:

• Adult patients aged ≥18 years.
• Confirmed diagnosis of metabolic dysfunction-associated steatotic liver disease (MASLD) based on clinical, laboratory, and imaging criteria).
• Patients diagnosed with acute coronary syndrome (unstable angina, NSTEMI, or STEMI) for Group I.
• MASLD patients without clinical or electrocardiographic evidence of acute coronary syndrome for Group II.
• Patients who provide informed consent to participate in the study.

Exclusion Criteria:

• Patients with chronic liver diseases other than MASLD (e.g., viral hepatitis, autoimmune hepatitis, alcoholic liver disease).
• Patients with known hematological disorders affecting platelet count or function.
• Patients receiving antiplatelet or anticoagulant therapy prior to blood sampling.
• Patients with active infection, inflammatory diseases, or malignancy.
• Patients with chronic kidney disease or end-stage renal failure.
• Pregnant or lactating females.

The study population will consist of adult patients diagnosed with metabolic dysfunction-associated steatotic liver disease (MASLD) who are admitted to or evaluated at Sohag University Hospital. Eligible participants will include patients with confirmed MASLD based on clinical evaluation, laboratory findings, and imaging studies. The study will include two groups: patients with MASLD who present with acute coronary syndrome (ACS) and patients with MASLD without evidence of ACS.

Participants will be recruited from inpatient and outpatient services, including the cardiology and internal medicine departments. Demographic and clinical data, cardiovascular risk factors, and laboratory parameters-including mean platelet volume (MPV)-will be collected at baseline

IPD will not be shared due to privacy and confidentiality considerations