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Systemic Coagulation Inflammation Index Associated With Bleeding in Acute Coronary Syndrome
1Bursa City Hospital, Department of Cardiology, Health Sciences University.
Insights
The systemic coagulation-inflammation index (SCI) may predict bleeding complications in acute coronary syndrome (ACS) patients. Higher SCI scores were linked to increased in-hospital bleeding, but not mortality or other adverse events.
Area of Science:
- Cardiology
- Hematology
- Clinical Medicine
Background:
- Acute coronary syndrome (ACS) involves inflammation and coagulation system activation, which can impact patient outcomes.
- The systemic coagulation-inflammation index (SCI) integrates markers of both inflammation and coagulation.
- Previous studies suggest SCI is associated with clinical outcomes in various conditions.
Purpose of the Study:
- To investigate the relationship between the systemic coagulation-inflammation index (SCI) and in-hospital clinical events in patients with ACS.
- To determine if SCI can predict adverse outcomes such as acute kidney injury, cardiogenic shock, life-threatening arrhythmia, bleeding, and mortality in ACS patients.
Main Methods:
- A cohort of 396 adult patients diagnosed with ACS was included in the study.
- The SCI was calculated using platelet count, fibrinogen levels, and white blood cell (WBC) count.
- Patients were stratified into two groups based on SCI score: >100 and <100, and clinical characteristics were analyzed.
Main Results:
- Patients with SCI >100 exhibited significantly higher rates of in-hospital bleeding compared to those with SCI <100 (p<0.05).
- No significant association was found between SCI and other in-hospital events like acute kidney injury, cardiogenic shock, or life-threatening arrhythmias (p>0.05).
- The systemic coagulation-inflammation index (SCI) was not significantly associated with in-hospital mortality.
Conclusions:
- A higher systemic coagulation-inflammation index (SCI) may serve as a predictive marker for in-hospital bleeding complications in patients with acute coronary syndrome (ACS).
- SCI did not demonstrate a significant association with mortality or other major clinical events in this ACS cohort.
- Further research may refine the utility of SCI in risk stratification for ACS patients, particularly concerning bleeding risk.
Aim:
Assessment of the inflammatory component of acute coronary syndrome (ACS) and the degree of activation of the coagulation cascade may provide prognostic information. The systemic coagulation-inflammation index (SCI) assesses both inflammation and the coagulation system, and it has also been found to be associated with clinical outcomes. We investigated the relationship between SCI and in-hospital clinical events (acute kidney injury, cardiogenic shock, life-threatening arrhythmia, bleeding) and mortality.
Material And Methods:
The study included 396 patients aged ≥18 yrs who were hospitalized with a diagnosis of ACS. The SCI was calculated using the formula: platelet count (103 / µl) X fibrinogen (g / l) / white blood cell (WBC) count (103 / µl). Patients were divided into two groups according to whether their SCI score was >100 or <100, and the relationship between clinical and laboratory characteristics was analyzed accordingly.
Results:
The mean age of the patients was 61.4±12.2 years and 78.3 % (n=310) were male. The type of ACS was NSTEMI in 56.1 % (n=222). The responsible vessel was the left anterior descending artery (LAD) in 42.4 % of the patients (n=168). The mean SCI score was 97.5±47.1. WBC, neutrophil, and lymphocyte counts were higher in the SCI <100 group, whereas fibrinogen, C-reactive protein, and platelet count were higher in the SCI >100 group. Bleeding from any cause as an in-hospital complication was significantly higher in patients with SCI >100 (p<0.05). Other in-hospital events were not significantly associated with SCI (p>0.05).
Conclusions:
Bleeding in ACS patients was significantly more common in the group with SCI >100. Thus, SCI may be a useful parameter for predicting in-hospital bleeding complications in ACS. On the other hand, SCI was not associated with mortality and other in-hospital clinical events.
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