AIM   To explore the predictive value of platelet parameters on the prognosis of patients with acute heart failure (AHF).

  METHODS  500 patients with AHF who were admitted to Beijing Tiantan Hospital affiliated to Capital Medical University from May 2019 to May 2022 were selected as the study subjects. According to their prognosis, they were divided into poor prognosis group (n=125) and good prognosis group (n=375). Compare the differences between the two groups in general data, laboratory test indicators and platelet parameters. Pearson was used for correlation analysis, multiple logistic regression model was used for analysis of influencing factors, and ROC and calibration curve were used for evaluation of model differentiation and accuracy.

  RESULTS   After 6 months of follow-up, the age, heart rate, NYHA grade IV ratio, HFrEF ratio, HFmrEF ratio, NT-proBNP, LVESD, LVEDD, blood lactic acid, Cys-C, hs-CRP, PDW, MPV data of the poor prognosis group were significantly higher than those of the good prognosis group (all P<0.01), while the stroke ratio, atrial fibrillation ratio, BMI, systolic blood pressure, heart failure HFpEF, LVEF, hemoglobin data were significantly lower than those of the good prognosis group (all P<0.01); The results of multiple logistic regression model showed that NT-proBNP, age, NYHA grade, blood lactic acid, PDW and MPV were independent risk factors affecting the prognosis of AHF patients, while LVEF and hemoglobin were protective factors (all P<0.05); Pearson correlation analysis showed that the expression levels of PDW and MPV were negatively correlated with LVEF (r=−0.231, r=−0.408, P=0.032, P=0.006); The ROC curve showed that the AUC of platelet parameters PDW and MPV were 0.801 and 0.761 respectively when tested separately, and 0.854 (95% CI: 0.801～0.893) when tested jointly; Finally, the nomograph prediction model is constructed based on its key factors. The regression equation Logit (P)=−2.541+0.257*X1−0.226*X2+0.512*X3+0.436*X4−0.234*X5+0.306*X6+0.518*X7+0.641*X8; The ROC curve and calibration curve results show that the prediction model has good discrimination and accuracy.

  CONCLUSION  Platelet parameters are closely related to the prognosis of AHF patients. PDW and MPV are risk factors for poor prognosis of AHF patients, and their combined detection can improve the diagnostic efficacy of poor prognosis.