Inflammatory and Hematological Indices as Simple, Practical Severity Predictors of Microdysfunction Following...

Area of Science:

• Cardiology
• Hematology
• Biomarkers

Background:

• No-reflow and slow-flow phenomena are complications in cardiovascular interventions.
• C-reactive protein (CRP), high-sensitivity CRP (hsCRP), and various hematological indices are implicated as potential predictors.
• Hematological indices include platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), mean platelet volume (MPV), platelet distribution width (PDW), and red blood cell distribution width (RDW).

Purpose of the Study:

• To systematically evaluate the association between CRP, hsCRP, and hematological indices with the incidence of no-reflow and slow flow.
• To determine the predictive value of preangiographic CRP/hsCRP for these complications.

Main Methods:

• A meta-analysis was conducted on 21 clinical studies involving 7403 patients.
• Studies were retrieved from PubMed, EMBASE, Google Scholar, Clinical Trials, and Science Direct up to August 24, 2019.
• Pooled analysis was performed to calculate odds ratios (OR) and confidence intervals (CI) for various markers.

Main Results:

• Elevated hsCRP, NLR, PLR, and MPV were significantly associated with a higher incidence of no-reflow.
• No significant association was found between no-reflow risk and RDW or PDW.
• Higher CRP/hsCRP levels correlated with an increased rate of slow flow.
• Preangiographic CRP/hsCRP demonstrated independent predictive value for no-reflow and slow flow.

Conclusions:

• hsCRP, NLR, PLR, and MPV are significant predictors of no-reflow.
• CRP/hsCRP can independently predict both no-reflow and slow flow.
• These inflammatory and hematological markers offer valuable insights into predicting procedural outcomes in cardiology.