Prognostic value of blood count parameters in patients with acute coronary syndrome
Arsalan Majeed Adam1, Ather Hasan Rizvi1, Amna Haq1
1Dow University of Health Sciences (DUHS), Karachi, Pakistan.
Insights
The white blood cell to mean platelet volume ratio (WMR) effectively predicts 30-day mortality in acute coronary syndrome (ACS) patients. A higher WMR indicates increased risk, making it a valuable prognostic marker.
Area of Science:
- Cardiology
- Hematology
- Clinical Medicine
Background:
- Complete blood count (CBC) parameters are recognized predictors of long-term outcomes in acute coronary syndrome (ACS).
- The predictive value of CBC parameters for short-term mortality in ACS patients remains less explored.
- This study investigates CBC parameters for predicting 30-day mortality and major adverse cardiac events (MACE) in ACS.
Purpose of the Study:
- To evaluate the predictive capability of CBC parameters for 30-day mortality in ACS patients.
- To assess the association between the white blood cell to mean platelet volume ratio (WMR) and MACE within 30 days.
- To identify key CBC parameters that can serve as prognostic markers for short-term outcomes in ACS.
Main Methods:
- A prospective study involving 297 ACS patients.
- Assessment of baseline white blood cell (WBC) to mean platelet volume ratio (WMR) and other CBC parameters.
- Patients stratified into two groups based on WMR (<1000 and >1000) for 30-day follow-up.
- Multivariate COX regression analysis to determine hazard ratios (HR).
Main Results:
- WMR demonstrated the highest discriminative ability for predicting mortality among all CBC parameters.
- Patients with WMR > 1000 exhibited significantly higher mortality rates (p<0.001).
- Elevated WBC count, platelet count, WMR, platelet to lymphocyte ratio, and neutrophil to lymphocyte ratio were associated with MACE-positive outcomes.
- A WMR > 1000 was identified as the strongest biochemical marker for predicting mortality (HR=2.9, p=0.01).
Conclusions:
- The white blood cell to mean platelet volume ratio (WMR) is a potent predictor of 30-day mortality in ACS.
- WMR is an accessible and cost-effective prognostic marker for ACS patients.
- Routine use of WMR can aid in risk stratification and management of ACS.
Background:
Recent studies have shown that complete blood count (CBC) parameters can effectively predict long-term mortality and re-infarction rates in acute coronary syndrome (ACS). However, the role of these parameters in predicting short term mortality has not been studied extensively. The main objective of this study was to determine whether CBC parameters can predict 30-days mortality and the incidence of major adverse cardiac event (MACE) in ACS patients.
Methodology:
A total of 297 patients with ACS were recruited in this prospective study. The relationship of baseline white blood cell (WBC) to mean platelet volume ratio (WMR) with MACE and mortality was assessed during a 30-days follow up. The patients were divided into two groups: Group A [WMR<1000] and Group B [WMR>1000]. Multivariate COX regression was performed to calculate hazard ratios (HR).
Results:
WMR had the highest area under receiver operating characteristics curve and highest discriminative ability amongst all CBC parameters in predicting mortality. Patients in Group B had a higher mortality rate (p<0.001) than patients in Group A. WBC count (p=0.02), platelet count (p=0.04), WMR (p=0.008), platelet to lymphocyte ratio (p<0.001) and neutrophil to lymphocyte ratio (p=0.03) were significantly higher in the MACE-positive group as compared to MACE-negative. In multivariate cox regression analysis, WMR>1000 (HR=2.9, 95% confidence interval 1.3-6.5, p=0.01) was found to be strongest biochemical marker in predicting mortality.
Conclusion:
WMR is an easily accessible and an inexpensive indicator, which may be used as a prognostic marker in patients with ACS.
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