Introduction: Platelet activation plays an important role in the pathophysiology of non-ST elevation acute coronary syndromes (ACS). Mean platelet volume (MPV), an indicator of platelet reactivity, was previously associated with an increased risk of acute coronary events.

Objective: To investigate the MPV variability in young patients presenting with NSTEMI, as compared to young patients with cardiovascular risk factors and no overt ischemic cardiac disease, as well as with elderly patients presenting with NSTEMI.

Methods: We analyzed data from 174 patients admitted in our cardiology department between January 2009 and December 2010: 35 patients younger than 45 years of age with NSTEMI, 41 patients younger than 45 without ACS and 98 patients older than 45 with NSTEMI.

Results: Young patients with NSTEMI had a significantly higher mean MPV (8.88 ± 1.14fl) than young patients without ACS (8.31 ± 0.37fl, p<0.01), while the older subjects with NSTEMI had the highest mean MPV (9.48 ± 1.35fl, p=0.02). MPV correlated with age (r=0.375, p<0.0001). After a multivariate analysis, elevated levels of MPV were independent predictors of NSTEMI in young patients (odds ratio [OR] 2.75, 95% CI 1.04–7.92, p=0.04), while hypertension (OR 0.34, 95% CI 0.6–1.78, p=0.20), dyslipidemia (OR 1.61, 95% CI 0.17–14.51, p=0.67), obesity (OR 5.77, 95% CI 0.80–41.53, p=0.08) and smoking status (OR 8.97, 95% CI 0.84–95.26, p=0.06) were not.

Conclusion: NSTEMI is associated with high MPV in old as well as in young patients. Elevated MPV is predictive for NSTEMI in young patients, separately of a high cardiovascular risk profile.