Differential value of eosinophil count in acute coronary syndrome among elderly patients
Isa Sincer1, Yilmaz Gunes1, Asli Kurtar Mansiroglu1
1Department of Cardiology, Abant Izzet Baysal Universitesi, Bolu, Turkey.
Insights
In elderly patients with acute coronary syndrome (ACS), higher blood eosinophil (EOS) counts indicate less severe conditions like unstable angina pectoris (UAP). Lower EOS levels are associated with more severe myocardial infarction (MI), suggesting EOS as a potential diagnostic marker.
Area of Science:
- Cardiology
- Hematology
- Clinical Diagnostics
Background:
- Acute coronary syndrome (ACS) encompasses unstable angina pectoris (UAP), non-ST elevation myocardial infarction (NSTEMI), and ST elevation myocardial infarction (STEMI).
- Differentiating ACS subtypes is crucial for timely and appropriate treatment strategies.
- Eosinophil (EOS) counts, a component of complete blood count, have been explored for their role in various inflammatory conditions.
Purpose of the Study:
- To evaluate eosinophil (EOS) counts in elderly patients diagnosed with ACS.
- To determine the diagnostic value of EOS counts in distinguishing between UAP and myocardial infarction (MI) (NSTEMI or STEMI).
Main Methods:
- Retrospective analysis of 296 elderly ACS patients categorized into UAP (63), NSTEMI (154), and STEMI (73) groups.
- Collection of demographic data, blood pressure, complete blood count (including EOS), and biochemical parameters prior to coronary angiography.
- Statistical analysis using Kruskal-Wallis and Mann-Whitney U-tests, with receiver operating curve (ROC) analysis for diagnostic accuracy.
Main Results:
- EOS counts were significantly higher in the UAP group (0.134 u/mm³) compared to NSTEMI (0.085 u/mm³) and STEMI (0.020 u/mm³) groups (p < .001 for all comparisons).
- A statistically significant difference in EOS counts was observed across all three ACS subgroups (UAP, NSTEMI, STEMI).
- ROC analysis indicated an EOS cut-off of >0.083 u/mm³ had 79% sensitivity and 57% specificity for identifying UAP within the ACS cohort (AUC = 0.686).
Conclusions:
- Eosinophil (EOS) counts exhibit an inverse relationship with the severity of acute coronary syndrome (ACS) in elderly patients.
- Higher EOS levels are associated with less severe ACS (UAP), while lower levels correlate with more severe forms (MI).
- EOS count may serve as a valuable, easily accessible biomarker for differentiating ACS subtypes in the elderly population.
Abstract:
We aimed to search eosinophil (EOS) counts in elderly acute coronary syndrome (ACS) subjects and to investigate its value for discrimation between unstable angina pectoris (UAP) and myocardial infarction (MI) [non-ST elevation MI (NSTEMI) or ST elevation MI (STEMI)]. The patients were divided into three groups regarding the diagnosis: patients with UAP (63), with NSTEMI (154), and with STEMI (73). General characteristics such as gender, age, systolic and diastolic blood pressure were obtained from patients' files. Complete blood count and biochemical parameters were measured before coronary angiography. EOS was found significantly higher in UAP (0.134 (0.002-0.746) u/mm3) compared to NSTEMI (0.085(0.001-0.601) u/mm3) and STEMI (0.020(0.001-0.479) u/mm3) groups. Kruskal-Wallis test with Bonferroni-corrected Mann-Whitney U-test revealed that EOS count was significantly different between UAP and NSTEMI (p < .001), UAP and STEMI (p < .001) and NSTEMI and STEMI (p < .001) groups. A receiver operating curve (ROC) analysis revealed that a cut-off >0.083 u/mm3 EOS value had a sensitivity of 79% and specificity of 57% for determination of ACS as UAP (AUC = 0.686, 95% CI, 0.617-0.755). In the present study, we detected an inverse relationship between the number of blood eosinophil count and the severity of ACS subgroups in elderly patients with higher counts in UAP than MI groups.
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