Hubungan Platelet Distribution Width dengan Jumlah Lesi Arteri Koroner pada Pasien Sindrom Koroner Akut

Abstract

Background: Acute Coronary Syndrome (ACS) is a leading cause of global mortality involving the complex pathogenesis of atherosclerosis and thrombosis, where platelet activation and aggregation play a central role. This condition is characterized by platelet activation and inflammation, which contribute to the progression of atherosclerotic lesions. Platelet Distribution Width (PDW), as a marker of platelet heterogeneity indicating larger and more active platelets, has the potential to predict coronary lesion complexity. Objective: This study aimed to determine the relationship between platelet distribution width (PDW) and the number of coronary artery lesions in patients with ACS. Methods: This retrospective cross-sectional analytical observational study involved 111 ACS patients who underwent coronary angiography and met the inclusion criteria at Adam Malik Hospital, Medan. Bivariate analysis was performed using the Mann- Whitney and Chi-Square tests, while diagnostic testing utilized the ROC curve to determine the cut-off value. Results: The majority of patients (57.7%) had multi- vessel lesions. The median PDW value was significantly higher in the multi- vessel group (11.0 fL) compared to the single-vessel group (10.7 fL) (p=0.002). There was a significant association between PDW ≥ 10.25 fL and the risk of multi-vessel lesions (p=0.001). The discriminative ability of PDW to predict lesion number was relatively weak (AUC=0.68) with 95% sensitivity and 43% specificity. Conclusion: PDW levels were significantly associated with the number of coronary artery lesions in ACS patients, suggesting that increased PDW may serve as a marker of enhanced thrombopoietic activity in multi-vessel disease. Keywords: Platelet Distribution Width (PDW), Acute Coronary Syndrome (ACS), Coronary Artery Lesions, Multi-vessel Disease, AUC