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Plateletcrit and red cell distribution width are independent predictors of the slow coronary flow phenomenon
Ibrahim Akpinar1, Muhammet Rasit Sayin1, Yusuf Cemil Gursoy1
1Bulent Ecevit University, Faculty of Medicine, Department of Cardiology, Zonguldak, 67600, Turkey.
Insights
Slow coronary flow (SCF) is linked to higher white blood cell counts and plateletcrit (PCT), suggesting inflammation. Increased red cell distribution width (RDW) and PCT may predict SCF, potentially due to altered blood cell properties.
Area of Science:
- Cardiology
- Hematology
- Vascular Biology
Background:
- Endothelial dysfunction is implicated in slow coronary flow (SCF).
- Previous studies have not comprehensively analyzed blood cellular components in SCF.
- This study investigates the association between SCF and complete blood count parameters.
Purpose of the Study:
- To determine the relationship between slow coronary flow (SCF) and various whole blood cell counts.
- To identify potential hematological predictors of SCF.
Main Methods:
- Retrospective analysis of 17,315 coronary angiography records (January 2006 - December 2012).
- Comparison of 146 SCF patients with 148 control patients with normal coronary arteries.
- Evaluation of demographic data, complete blood count, and biochemical parameters.
Main Results:
- SCF patients exhibited higher white blood cell (WBC) counts, red cell distribution width (RDW), platelets, plateletcrit (PCT), mean platelet volume, platelet distribution width (PDW), and neutrophil counts compared to controls.
- Positive PCT and elevated RDW were identified as independent predictors of SCF.
- Smoker percentage and body mass index were also higher in SCF patients.
Conclusions:
- Elevated WBC and neutrophil counts in SCF patients suggest an underlying subclinical inflammatory process.
- Increased RDW and PDW may contribute to microvascular resistance by impairing blood cell deformability.
- Plateletcrit (PCT) is a reliable indicator of total platelet mass and a potential predictor for SCF.
Background And Purpose:
Endothelial dysfunction may play a role in the pathogenesis of the slow coronary flow (SCF) phenomenon. A detailed examination of blood cellular components has not been performed for this condition. We investigated the relationship between SCF and whole blood cell counts.
Method:
Records of 17,315 patients who underwent coronary angiography between January 2006 and December 2012 were evaluated retrospectively. A total of 146 patients with SCF were compared with 148 patients with normal coronary arteries according to demographic data, complete blood count, and biochemical parameters.
Results:
The following parameters were significantly higher in SCF patients than in patients with normal coronary arteries: percentage of smokers (36.3% vs. 25%, p=0.036), body mass index (26.69 ± 2.84 vs. 26.07 ± 3.15, p=0.049), white blood cells (WBCs) (7.52 ± 1.43 × 10(3)mm(-3) vs. 7.01 ± 1.42 × 10(3)mm(-3), p=0.002), red cell distribution width (RDW) (13.68 ± 1.42% vs. 13.15 ± 1.13%, p<0.001), platelets (250.29 ± 50.96 × 10(3)mm(-3) vs. 226.10 ± 38.02 × 10(3)mm(-3), p<0.001), plateletcrit (PCT) (0.214 ± 0.40% vs. 0.184 ±0.29%, p<0.001), mean platelet volume (8.63 ± 1.10fL vs. 8.22 ± 0.83 fL, p<0.001), platelet distribution width (PDW) (16.58 ± 0.76% vs. 16.45 ± 0.57%, p=0.028), and neutrophils (4.44 ± 1.25 × 10(3)mm(-3) vs. 4.12 ± 1.24 × 10(3)mm(-3), p=0.029). Positive PCT values [odds ratio (OR), 4.165; 95% confidence interval (CI), 2.493-6.959; p<0.001) and RDW (OR, 1.304; 95% CI, 1.034-1.645; p=0.025) were independent predictors of SCF.
Conclusion:
Although within the normal range, the increased numbers of WBCs and neutrophils in patients with SCF suggest that SCF may be a subclinical inflammatory condition. Furthermore, increased RDW and PDW in SCF patients may cause microvascular blood flow resistance due to impaired cell deformability. The PCT provides reliable data regarding total platelet mass and may be a useful predictor of SCF.
