This study aimed to investigate the predictive value of mean platelet volume/platelet count ratio (MPR) for coronary plaque features in patients with ST segment elevation myocardial infarction (STEMI). A total of 275 STEMI patients undergoing preintervention optical coherence tomography examination were included, with 142 categorized as plaque rupture (PR) and 133 as plaque erosion (PE). Multivariable logistic regression showed higher MPR was an independent predictor of PR (tertile 3 vs tertile 1, odds ratio: 6.257, 95% confidence interval: 1.586–24.686, P = 0.009). MPR showed better diagnostic performance than other platelet indices. The optimal MPR threshold for diagnosing PR was 0.0473 (sensitivity: 0.721, specificity: 0.647). When added to models of established risk factors, MPR significantly improved the predictive accuracy of PR (area under the curve: 0.767 vs 0.722, P _difference = 0.004). In conclusion, for STEMI patients, MPR was an independent predictor of PR and improved diagnostic performance for PR.

本研究旨在探讨平均血小板体积/血小板计数比 (MPR) 对 ST 段抬高型心肌梗死 (STEMI) 患者冠状动脉斑块特征的预测价值。共纳入 275 例接受介入前光学相干断层扫描检查的 STEMI 患者，其中 142 例为斑块破裂（PR），133 例为斑块侵蚀（PE）。多变量逻辑回归显示更高的 MPR 是 PR 的独立预测因子（三分位数 3 与三分位数 1，优势比：6.257，95% 置信区间：1.586-24.686，P= 0.009)。MPR 显示出比其他血小板指数更好的诊断性能。诊断 PR 的最佳 MPR 阈值为 0.0473（敏感性：0.721，特异性：0.647）。当添加到已建立的风险因素模型中时，MPR 显着提高了 PR 的预测准确性（曲线下面积：0.767 对 0.722，P _差异= 0.004）。总之，对于 STEMI 患者，MPR 是 PR 的独立预测因子，并提高了 PR 的诊断性能。