Correlations between hematological indicators and other known markers in acute coronary syndromes

Abstract

Introduction:Recently, many hematologic markers have identified as prognostic and diagnostic indicators in different acute coronary syndrome (ACS) patients. In particular, neutrophil / lymphocyte ratio (NLR) and platelet / lymphocyte ratio (PLR) are recognized as markers in the diagnosis and prognosis of ACS. In this study, our aim was to investigate the correlation between the diagnostic yield of PLR and NLR values and other markers such as troponin in all ACS patients. Material and methods:319 patients admitted to our hospital with ACS and 283 control patients were included in the study. Leukocyte, neutrophil, platelet, lymphocyte counts, PLR, NLR and high sensitive troponin I (HsTnI) measurements were taken.Results: Leukocyte, neutrophil and platelet counts were significantly higher in the ACS group than the controls (p <0.001). Lymphocyte count was significantly lower in the ACS group than the controls (p <0.001). NLR and PLR were found to be significantly higher in the ACS group than the controls (4.0 ± 3.3 vs 2.1 ± 1.4 and 126.3 ± 68.9 vs 106.9 ± 49.4, p <0.001, respectively). NLR was showed significant correlation with HsTnI, PLR, angina time, presence of ST elevation and T wave negativity (p <0.05), and PLR revealed significant correlation with NLR, HsTnI, ST elevation and T wave negativity (p <0.05). Conclusion:Hematologic markers were found to be significantly higher in the ACS group than the controls. The difference also continued in subgroup analyzes. NLR and PLR correlated with many other ACS indicators.Key words: Platelet lymphocyte ratio, neutrophil lymphocyte ratio, acute coronary syndrome, troponin. Abstract

Predictive Value of Hematologic Indices in the Diagnosis of Acute Coronary Syndrome

“…The previous study also showed PLR is elevated in both ACS and SCAD compared to healthy controls [32], [37], [38]. This study shows that elevated PLR is mainly due to lower lymphocyte count.…”

“…In this research, both NLR and PLR are higher in ACS compared to SCAD. Similarly, the previous study showed NLR is elevated in both ACS and SCAD compared to healthy controls [32], [33], [34]. Higher NLR in ACS is related to acute and higher-grade inflammation response which neutrophils act as acute phase pro-inflammatory agents and lymphocytes as anti-inflammatory agents.…”

“…Low lymphocyte count in ACS condition may be due to cortisol release or lymphocyte migration from blood circulation [37], [38]. Platelet count in ACS and SCAD showed inconsistent results, several studies showed platelet count is higher in ACS group compared to SCAD and healthy control [11], [39], while others showed lower platelet count [32], [40]. A study also showed platelet count in myocardial infarction patient is higher compared to healthy control but lower in unstable angina patient [41].…”

“…In this research, the cut-off point of NLR was 3.187, which higher NLR is suggestive for ACS diagnosis. The previous study showed that NLR above 2.5 could diagnose ACS with the sensitivity of 63.6% and specificity 80.2% [32]. A meta-analysis also showed that NLR cut-off point from 1.95 to 3.97 could predict severe atherosclerotic lesion [45].…”

Serum Presepsin Levels in Patients with Decompensated Heart Failure

“…We did not include patients over 70 years old based on the study of Chenevier-Gobeaux et al (24) They revealed significantly increased PSP levels in patients older than 70 years old compared to patients younger than 70 years old. (24) Biochemical and hematological markers are important predictors in development and diagnosis of cardiovascular diseases (25,26). In our previous study, we also reported that PSP levels were significantly elevated in acute ST elevation myocardial infarction patients together with high sensitivity troponins, which may be a novel supporting marker for acute myocardial infarction.…”