Prognostic value of blood count parameters in patients with acute coronary syndrome

Adam, Arsalan Majeed; Rizvi, Ather Hasan; Haq, Amna; Naseem, Rabia; Rehan, Aiman; Shaikh, Ali Tariq; Abbas, Abdul Haseeb; Godil, Ansab; Ali, Arif; Mallick, Muhammad Saad Ali; Khan, Muhammad Shahzeb; Lashari, Muhammad Nawaz

doi:10.1016/j.ihj.2017.06.017

Cited by 19 publications

(21 citation statements)

References 35 publications

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“…Cut off point by Arsalan MA et al (2017) that comes from ROC curve were > 1068.75 as an optimal cut off point to predict MACE with lower sensitivity and specificity comapared to this study which is 68.3% and 63,7% (AUC 0.734, p<0.001, 95% CI 0.656-0.812). Other studies also found lower optimal cutoff point compared to this study which is > 750 15 . Possible cause of variability in WMR cut-off point is because of difference in population where Arsalan et al (2017) include all patient with ACS and Dehghani et al (2015) include patient with metabolic syndrome also possibly caused by difference in Hematology Analyzer device and calibration 14,15 .…”

Section: Discussioncontrasting

confidence: 72%

White Blood Cell Count Mean Platelet Volume Ratio as A Predictor of Major Adverse Cardiovascular Event in Acute Non St-Elevation Myocardial Infarction (NSTEMI)

Saragih¹,

Nasution²,

Andra³

et al. 2018

IJPTR

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Background :Recent studies have shown that complete blood count analysis can become a strong parameter to predict long term complication and reinfarction in acute coronary syndrome (ACS) but there are still no parameter known for predicting short term and inhospital complication. White Blood Cell Count Mean Platelet Volume Ratio (WMR) is one of parameter from complete blood count analysis that can be used for predicting Major Adverse Cardiovascular Event (MACE) that has not been studied extensively. The main objective of this study is to determine whether WMR can be used as a MACE predictor for NSTEMI patient during hospitalization. Method :A total of 104 patients with NSTEMI who undergo treatment at Haji Adam Malik Hospital since October 2017 until April 2018 were recruited in this prospective cohort study. The relationship of baseline White Blood Cell Count (WBC) to Mean Platelet Volume ratio (WMR) with MACE was assessed in hospital. The patients were divided into two groups: Group A [MACE-positive] and Group B [MACE-negative]. Multivariate COX regression was performed to calculate odds ratio (OR). Result: In the ROC curve analysis, WMR had the highest area under receiver operating characteristics curve and highest discriminative ability amongst all CBC parameters in predicting MACE , the cutoff value of WMR in the prediction of MACE was 7.65 mm (AUC 0.74, 95% CI 0.645-0.835, p<0.001). The NSTEMI group with dengan WMR ≥ 1118 had a higher incidence of MACE than the group with WMR < 1118 of 24 people (70.6%) versus 10 people (29.4%). WMR ≥ 1118 is considered to predict the incidence of MACE with a sensitivity of 70.6%, a specificity of 70%, a negative predictive value (NPV) of 83% and a positive predictive value (PPV) of 53%. Multivariate analysis showed that WMR ≥ 1118 was an independent factor that could predict the occurrence of MACE during the hospitalization period (OR 10.49, 95% CI 3.01-36.65, p<0.001). Conclusion: WMR is an inexpensive indicator, can be done easily and can become an independent factor to predict MACE during hospitalization in NSTEMI patient with OR 10.49.

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Section: Discussioncontrasting

confidence: 72%

White Blood Cell Count Mean Platelet Volume Ratio as A Predictor of Major Adverse Cardiovascular Event in Acute Non St-Elevation Myocardial Infarction (NSTEMI)

Saragih¹,

Nasution²,

Andra³

et al. 2018

IJPTR

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“…the study by Adam AM et al, was comprised of large sample size compared to the present study (n=297 vs n=50) and the study by Adam AM et al, evaluated not only WMR in combination with cardiac enzymes. 10 Also the study by Adam AM et al, had higher rate of MACE (34.34% compared to 10% in the present study). 10 It is speculated that, WMR incorporates two of the most prominent inflammatory mediators, namely MPV and WBC count, into a single value.…”

Section: Resultssupporting

confidence: 47%

“…10 Also the study by Adam AM et al, had higher rate of MACE (34.34% compared to 10% in the present study). 10 It is speculated that, WMR incorporates two of the most prominent inflammatory mediators, namely MPV and WBC count, into a single value. MPV is a measure of platelet size, and larger platelets are known to be enzymatically more active and have a greater thrombotic potential and are thus more likely to occlude the coronary vessels.…”

Section: Resultssupporting

confidence: 47%

“…9 The observation of the present study was also partly in agreement with a recent study by Adam AM et al, who in their study illustrated that admission MPV level is not a predictor of cardiovascular events at 30 days of follow-up. 10 In contrast, a study by Estévez-Loureiro et al, found that raised MPV is an independent predictor of 30-day mortality in patients with STEMI undergoing primary PCI. 15 Vagdatli et al, stated that platelet distribution width (PDW), a measure of variability in platelet size, is a more specific marker of platelet activation than MPV.…”

Section: Resultsmentioning

confidence: 89%

“…Considering the sensitivity of WMR as 69% with mortality rate of 14% based on the study by Adam AM et al, the minimum sample size required was 25 cases with ACS. 10 Inclusion criteria included patients with ACS. ACS patients were identified by using the following criteria: NSTEMI was confirmed if patients had raised cardiac enzymes without detectable ST-segment elevation on the electrocardiogram (ECG).…”

Section: Methodsmentioning

confidence: 99%

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Usefulness of white blood cell count to mean platelet volume ratio in predicting short term, 30 days major adverse cardiac events in patients presenting with acute coronary syndrome

Shanker

Ramachandran

2020

Int J Res Med Sci

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Background: The role of white blood cell (WBC) to mean platelet volume (MPV) ratio (WMR) in predicting short-term major adverse cardiac events (MACE) in patients presenting with acute coronary syndrome (ACS) has not been studied extensively. We aimed to determine whether WMR can predict short-term (30 days) MACE in ACS patients.Methods: This hospital-based prospective cohort study was undertaken at a tertiary-care teaching hospital in India from January 2018 to December 2018. Fifty patients presenting with ACS to undergo primary percutaneous intervention were evaluated for WMR and short-term MACE.Results: Receiver operating characteristic (ROC) curve showed cut-off value of WMR as 1059 with area under the ROC curve of 0.825 (SE=0.074; 95% CI: 0.679-0.971; p=0.001). MACE was noted in 10 patients (20%) and mortality in 4 patients (8%). WMR with cut-off value of 1059 was significant and highly accurate in predicting MACE (diagnostic accuracy: 72%, sensitivity: 80%, specificity: 70%, positive predictive value: 40%, negative predictive value: 93.33%, p=0.016, and positive likelihood ratio: 2.67, negative likelihood ratio: 0.29). Risk of short-term MACE increases with higher respiratory rate, creatine kinase and creatine kinase myocardial band, alanine aminotransferase, WBC count, neutrophils, neutrophil to lymphocyte ratio, total bilirubin, aspartate aminotransferase, lymphocytes, uric acid, lower SBP, DBP, Troponin I, red blood cell count, and ejection fraction and clinical presentation such as, palpitations, sweating, giddiness, loss of consciousness, higher Killip class, and diagnosis of inferior wall myocardial infarction.Conclusions: Higher WMR values on admission (≥1059) are associated with worse short-term outcomes in patients with ACS and independently predict short-term MACE.

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Evaluation of Effectiveness and Tolerability of Fondaparinux in the Management of Symptomatic Acute Coronary Syndrome: A Real-World Evidence-Based Study on an Indian Population

Dalal

Mohan

Sathe³

et al. 2022

Cardiol Ther

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Introduction : Fondaparinux is a low molecular weight heparin anticoagulant used to manage the full spectrum of acute coronary syndrome (ACS) patients and has proved its efficacy and safety in multiple clinical trials. However, there are limited data available showing whether the same results could be reproduced in real-world practice on an Indian population. Our objective was to determine the effectiveness and tolerability of fondaparinux in the management of symptomatic ACS in real-world clinical practice. Methods: The EMR data of hospitalized ACS patients (n = 611), from January 2015 to January 2020, representing UA or NSTEMI or STEMI and were prescribed fondaparinux (2.5 mg once daily) to manage ACS were analyzed. The effectiveness was analyzed as recurrence of ACS and tolerability as total incidence of major bleeding during hospitalization, at 30 days and 180 days. Appropriate statistical analysis was used with a statistically significance of p value \ 0.05.

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Prognostic value of blood count parameters in patients with acute coronary syndrome

Abstract: WMR is an easily accessible and an inexpensive indicator, which may be used as a prognostic marker in patients with ACS.

Cited by 19 publications

References 35 publications

White Blood Cell Count Mean Platelet Volume Ratio as A Predictor of Major Adverse Cardiovascular Event in Acute Non St-Elevation Myocardial Infarction (NSTEMI)

White Blood Cell Count Mean Platelet Volume Ratio as A Predictor of Major Adverse Cardiovascular Event in Acute Non St-Elevation Myocardial Infarction (NSTEMI)

Usefulness of white blood cell count to mean platelet volume ratio in predicting short term, 30 days major adverse cardiac events in patients presenting with acute coronary syndrome

Evaluation of Effectiveness and Tolerability of Fondaparinux in the Management of Symptomatic Acute Coronary Syndrome: A Real-World Evidence-Based Study on an Indian Population

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