Relationship between Platelet Distribution Width (PDW) and GRACE Risk Score to Assess the In-Hospital Outcome in Patients with Acute Coronary Syndrome

Open Access

Abstract

Background: Acute coronary syndrome (ACS) is a leading cause of morbidity and in-hospital mortality worldwide, highlighting the need for simple, cost-effective biomarkers for early risk stratification. This study aimed to determine the relationship between platelet distribution width (PDW) and GRACE Risk Score with adverse in-hospital outcomes in patients with ACS. Methods & Materials: This cross-sectional observational study was carried out in the Department of Cardiology at Mymensingh Medical College Hospital, Mymensingh, Bangladesh, from January 2024 to December 2024. A purposive sample of 80 patients who were admitted with ACS (STEMI, NSTEMI, and unstable angina) was used. PDW was measured from a routine complete blood count at admission, and GRACE risk scores were calculated. In-hospital adverse events were recorded. Data were entered and analyzed using SPSS version 26. Results: The mean age of the participants was 61.8±10.9 years, with the majority being males (72.5%). The most prevalent type of ACS was STEMI (42.5%). Mean PDW was 16.82±2.5 fL, and mean GRACE score was 135.72±24.8 fL. In 35% of the patients, elevated PDW (>17.0 fL) was detected. Adverse events occurred in 30% of patients. High PDW (p=0.004) and elevated GRACE risk (p=0.002) were significantly associated with outcomes. Logistic regression showed PDW (adjusted OR 3.92; p=0.017) and GRACE score (adjusted OR 1.31; p=0.022) independently predicted in-hospital events. Conclusion: Platelet distribution width (PDW), an easily obtainable parameter, is associated with adverse in-hospital outcomes in ACS and improves GRACE score–based risk stratification, especially in resource-limited settings.