Role of complete blood count, antioxidants, and total antioxidant capacity in the pathophysiology of acute coronary syndrome

Abstract

Acute Coronary Syndrome (ACS) resulting from sudden rupture of arterial plaques with exposure of highly thrombogenic fatty deposits in the coronary arteries is one of the most common causes of mortality worldwide, needs further attention. In this case control study, a total of 138 patients with ACS and 134 non-ACS controls were enrolled. The Red Blood Cell (RBC) count, hemoglobin, and hematocrit were significantly lower in patients. The White Blood Cell (WBC) and platelet counts, and neutrophil to lymphocyte ratio were significantly higher in patients (11.76 ± 2.49 × 10 6 cells/mL, 343.80 ± 113.76 × 10 9 cells/L, and 3.88 ± 2.24, respectively), which strongly indicated inflammatory responses. The serum and RBC lysate reduced glutathione (GSH), antioxidant vitamins -C, D and alpha-tocopherol, total bilirubin, and Total Antioxidant Capacity (TAC) were significantly lower in ACS patients (3.78 ± 1.53 and 384.21 ± 184.86 µmol/L, 0.30 ± 0.22 mg/dL, 49.46 ± 47.11 ng/mL, 2.66 ± 3.67 µg/mL, 0.51 ± 0.27 mg/dL and 533.61 ± 232.47 µmol/L, respectively). Their serum GSH showed significant positive correlation with vitamin C and hemoglobin, and significant negative correlations were found between WBC count and serum GSH, and platelet count with TAC. Neutrophils and platelets play pivotal roles in mediating inflammatory responses, and significant reduction of antioxidants cause increased oxidative stress in patients with ACS, indicating that administration of antioxidant vitamins could reduce oxidative stress and inflammatory conditions.