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Value of Hematological and Coagulation Parameters as Prognostic Factors in Acute Coronary Syndromes
Elena Emilia Babes1,2, Dana Carmen Zaha2,3, Delia Mirela Tit4,5
1Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania.
Insights
Hematological and coagulation biomarkers like RDW, WBC, NEU, and PT can predict mortality and complications in acute coronary syndrome (ACS) patients. These markers aid in risk stratification and predicting specific adverse events such as heart failure and rhythm disturbances.
Area of Science:
- Cardiology
- Hematology
- Clinical Biomarkers
Background:
- Acute coronary syndromes (ACS) are a leading cause of mortality and morbidity.
- Effective risk stratification is crucial for managing ACS patients and improving outcomes.
- Identifying reliable predictors of in-hospital mortality and complications is essential for timely intervention.
Purpose of the Study:
- To evaluate hematological and coagulation biomarkers as predictors of in-hospital mortality and complications in ACS patients.
- To assess the accuracy of specific biomarkers in predicting adverse outcomes.
- To explore the utility of these biomarkers in risk stratification of ACS patients.
Main Methods:
- Retrospective observational study of 936 ACS patients admitted between January-December 2019.
- Collection of hematological and coagulation parameters at admission.
- Recording of adverse events including death, ventricular rhythm disturbances, atrial fibrillation, heart failure, re-infarction, and stroke during hospitalization.
Main Results:
- Red cell distribution width (RDW), white blood cells (WBC), neutrophils (NEU), and prothrombin time (PT) were significant predictors of in-hospital mortality.
- RDW, WBC, NEU, and PT also demonstrated accuracy in predicting in-hospital complications.
- RDW accurately predicted heart failure in non-ST-elevation myocardial infarction (NSTEMI) patients, while WBC and NEU predicted ventricular rhythm disturbances.
Conclusions:
- Hematological and coagulation parameters, specifically RDW, WBC, NEU, and PT, are valuable tools for risk stratification in ACS patients.
- These biomarkers can predict both mortality and in-hospital complications.
- RDW, WBC, and NEU show specific utility in predicting heart failure and rhythm disturbances, respectively.
Abstract:
The values of hematological and coagulation biomarkers were evaluated as predictors of in hospital mortality and complications, in patients with acute coronary syndromes (ACS). This retrospective observational study enrolled 936 ACS subjects admitted to the Clinical Emergency Hospital of Oradea, Romania, between January-December 2019. Hematological and coagulation parameters were obtained at admission. During hospitalization, the following adverse events were recorded: death, ventricular rhythm disturbances, atrial fibrillation, heart failure, re-infarction, and stroke. Accuracy of hematological and coagulation parameters as predictors of adverse outcome were also evaluated. The diagnosis was unstable angina in 442 patients (47.22%), non-ST-elevation myocardial infarction (NSTEMI) in 113 patients (12.1%) and ST-elevation myocardial infarction (STEMI) in 381 patients (40.70%); 87 patients (9.29%) died during hospitalization and 193 (20.7%) developed complications. Predictors for in hospital mortality were as follows: red cell distribution width (RDW) (AUC 0.691, p < 0.0001), white blood cells (WBC) (AUC 0.684, p < 0.0001), neutrophils (NEU) (AUC 0.684, p < 0.0001), and prothrombin time (PT) (AUC 0.765, p < 0.0001). WBC (AUC 0.659, p < 0.0001), NEU (AUC 0.664, p < 0.0001), RDW (AUC 0.669, p < 0.0001), and PT (AUC 0.669, 95% CI 0.622-0.714, p < 0.0001) also had accuracy for complications prediction. RDW had a good ability to predict heart failure in NSTEMI patients (AUC 0.832, p < 0.0001). An acceptable ability to predict ventricular rhythm disturbances occurrence had WBC (AUC 0.758, p < 0.0001) and NEU (AUC 0.772, p < 0.0001). Hematological and coagulation parameters can help in risk stratification of ACS patients. RDW, WBC, NEU, and PT were able to predict mortality and in-hospital complications in ACS patients. RDW has a good accuracy in predicting complications and heart failure in NSTEMI patients. WBC and NEU are good predictors for ventricular rhythm disturbances.
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