Association between White Blood Cell to Mean Platelet Volume Ratio (WMR) with Troponin for Refractory Angina Prediction in NSTE-ACS patients

Abstract

Hematological parameters provide independent information as well as troponin in non-ST-Elevation-Acute-Coronary-Syndrome (NSTE-ACS) patient. Refractory angina in NSTE-ACS patients significantly transforms this optimal management due to risk enhancement. This study aims to prove the association of white blood cell (WBC) to mean platelet volume ratio (WMR) with troponin and authenticate the best parameter for refractory angina prediction in NSTE-ACS patients. This observational study was conducted in ICCU Dr. Soetomo General Hospital, Surabaya. There were 49 NSTE-ACS patients recruited as the study subject. Complete Blood Count (CBC), High Sensitivity Cardiac Troponin I (hs-cTnI) and CKMB examinations were conducted at the time of admission. We observed angina symptom for three months. The mean age of the patients was 60.8±8.67 years, and 75.5% of them were male. Elevated hs-cTnI level was found in 83.7% of study subjects. WMR significantly correlated with hs-cTnI (r=0.434 p=0.002). Refractory angina was found in 14.3% of study subjects. There was a positive moderate correlation of WMR and refractory angina (r=0.534 p=0.000), a positive moderate significant correlation of hs-cTnI and refractory angina (r=0.470 p=0.001). No significant correlation of other parameters. This study proved that WMR was an independent hematological predictor for refractory angina event in NSTE-ACS patients with higher significance level than hs-cTnI.