Prognostic factors in patients with acute coronary syndrome without ST segment elevation
Jessica Carolina Matos D'Almeida Santos1, Mário de Seixas Rocha, Marcos da Silva Araújo
1Hospital Português, Escola Bahiana de Medicina e Saúde Pública, Salvador, BA - Brazil. dalmeidajessica@gmail.com
Insights
For patients with acute coronary syndromes without ST segment elevation, renal function and lymphocyte count are key indicators. These markers help predict adverse cardiovascular events during hospitalization, aiding in risk stratification.
Area of Science:
- Cardiology
- Internal Medicine
- Clinical Laboratory Science
Background:
- Acute coronary syndromes (ACS) without ST segment elevation (SSE) carry risks for cardiovascular events.
- Inflammatory markers, hyperglycemia, and renal function are potential predictors of these events.
Purpose of the Study:
- To assess the impact of laboratory parameters on intra-hospital outcomes for patients with ACS without SSE.
- To identify specific laboratory markers that predict adverse events in this patient population.
Main Methods:
- Prospective evaluation of 195 patients admitted with ACS without SSE.
- Collection of demographic and clinical laboratory data during hospitalization.
- Analysis of laboratory parameters in relation to the occurrence of combined adverse events.
Main Results:
- Neutrophil/lymphocyte ratios and creatinine levels discriminated patients with adverse outcomes.
- Patients with adverse events had lower lymphocyte counts and glomerular filtration rates, and higher serum creatinine.
- Glomerular filtration rate and lymphocyte count were significant independent predictors of adverse outcomes.
Conclusions:
- Assessment of renal function and lymphocyte count offers valuable prognostic information for patients with ACS without SSE.
- These parameters can aid in the prognostic stratification of at-risk patients.
Background:
In patients with acute coronary syndromes (ACS) without ST segment elevation (SSE), it is suggested that a series of markers (inflammatory cells, hyperglycemia and renal function) can identify individuals with increased risk for cardiovascular events.
Objective:
To evaluate the impact of these laboratory parameters on intra-hospital outcomes of patients with ACS with no SSE.
Methods:
We prospectively evaluated 195 patients consecutively admitted with ACS with no SSE. Demographic and clinical laboratory data were recorded during the course of the hospitalization period in relation to the occurrence of combined events.
Results:
Mean age was 67 ± 12 years, and 52% were men. In analyzing the area under the ROC curve, only neutrophil/lymphocyte ratios (AUC: 70%, CI 95% 56%-82%, p = 0.006) and creatinine (AUC: 62%, CI 95% 50%-80%, p = 0.03) discriminated those patients with ACS with no SSE who presented an adverse outcome. The patients who suffered an adverse event during hospitalization had lower lymphocyte counts (1502 ± 731/mm ³ vs. 2020 ± 862/mm³; p = 0.002), lower glomerular filtration rates (51 ± 27 mL / min vs. 77 ± 34 mL/min; p < 0,001) and higher serum creatinine levels (2.1 ± 2.7 mg/dL vs. 1.1 ± 1.3 mg/dL; p = 0.047) than those who progressed through hospitalization without incident. The logistic regression analysis showed that variables remaining as independent and significant predictors were: glomerular filtration rate (OR: 1.03; CI 95%: 1.00 - 1.13, p = 0.002), and lymphocyte count (OR: 1.02; CI95%: 1.01 to 1.04, p = 0.03).
Conclusion:
Assessment of renal function and lymphocyte count provide potentially useful information for the prognostic stratification in patients with ACS with no SSE (Arq Bras Cardiol. 2013; [online].ahead print, PP.0-0).
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Acute Coronary Syndrome I: Introduction
01:26Acute Coronary Syndrome V: Nursing Management
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:27Angina II: Classification