高凝血活性的血小板在急性冠心症的病理機轉上是一個很重要的角色，而血小板容積曾被提出為血小板活性的指標。本研究的目的是評估血小板容積在急性冠心症病人的預測價值，並探討血小板容積與不同抗血小板藥物的關連性，以及血小板容積與病人預後的相關性。此研究收集了1103例急性冠心症的病人和472例非急性冠心症的病人，於住院時抽取血液檢體資料，並比較一年之間以及一年以後的血液資料。另外將病人區分成高血小板容積組(>9.0fl，305位)和低血小板容積組(<7.9fl，272位)，平均追蹤三年左右，比較全因死亡率、再發生急性冠心症的時間、標的血管再狹窄需介入治療的比率，以及中風的機率。此研究發現心肌梗塞的病人比非急性冠心症的病人有較高的血小板容積(8.6 ± 1.1 vs. 8.4 ± 1.0 fl, p=0.003)，但多變量分析中，血小板容積並非心肌梗塞的獨立因素。另外與急性冠心症發作當下的血小板容積做比較發現，血小板容積在急性冠心症發作後一年內(8.38 ±1.02 fl, p<0.001 )和一年後 (8.38 ± 0.94 fl, p<0.001) 都有下降的情形，至於使用不同抗血小板的藥物並不會對血小板容積有影響。最後，高血小板容積組有較多的心血管疾病風險因子，且相較低血小板容積組，高血小板容積組有較多34%的心血管併發症(p=0.047)，但多變量統計發現，與心血管併發症相關的主要是年齡和慢性腎病變而非血小板容積。我們的結論是急性冠心症的患者血小板容積會增加，但血小板容積並非心肌梗塞的獨立因子。血小板容積不會受不同的抗血小板藥物而影響。而平常時有較高血小板容積的病人有比較多的心血管風險因子，長期有較多的心血管併發症。血小板容積可能是心血管風險因子與心血管疾病中間的連結。

Platelets with high hemostatic activity play an important role in the pathophysiology of acute coronary syndrome (ACS), and mean platelet volume (MPV) has been proposed as an indicator of platelet reactivity. This study aimed to evaluate the predictive value of MPV and the responsive value of MPV with different antiplatelet agents in association with clinical outcomes of ACS patients. A total of 1103 patients with ACS and 472 patients without ACS were included. Blood samples were taken at hospital admission, at routine follow-up < 1 year and at >1 year. Patients were divided into a high MPV group (MPV >9.0 fl, n=305) and low MPV group (MPV <7.9 fl, n=272). Average follow-up time was around 3 years, and endpoints were all-cause mortality, time to recurrent ACS, target vessel re-intervention (TVR) and stroke. Results showed that MPV was significantly higher in patients with MI than in non-ACS patients (8.6 ± 1.1 vs. 8.4 ± 1.0 fl, p=0.003), but MPV was not an independent factor for MI in multivariable analysis. MPV decreased within 1 year (8.38 ±1.02 fl, p<0.001) and beyond 1 year (8.38 ± 0.94 fl, p<0.001) after ACS events. Changes in MPV were not significantly different between patients receiving clopidogrel and ticagrelor. The high MPV group had more cardiovascular risk factors than the low MPV group. The high MPV group also had a 34% increased risk of MACCE than the low MPV group (p=0.047), but age and CKD rather than MPV were associated with MACCE in multivariable analysis. In conclusion, mean platelet volume was increased in patients with ACS but was not an independent factor for MI. MPV was not affected by different antiplatelet drugs. Higher MPV was associated with more cardiovascular risk factors and more cardiovascular events. MPV may be a link between CV risk factors and CV outcomes

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