Value of Hematological and Coagulation Parameters as Prognostic Factors in Acute Coronary Syndromes

Abstract

The values of hematological and coagulation biomarkers were evaluated as predictors of in hospital mortality and complications, in patients with acute coronary syndromes (ACS). This retrospective observational study enrolled 936 ACS subjects admitted to the Clinical Emergency Hospital of Oradea, Romania, between January–December 2019. Hematological and coagulation parameters were obtained at admission. During hospitalization, the following adverse events were recorded: death, ventricular rhythm disturbances, atrial fibrillation, heart failure, re-infarction, and stroke. Accuracy of hematological and coagulation parameters as predictors of adverse outcome were also evaluated. The diagnosis was unstable angina in 442 patients (47.22%), non-ST-elevation myocardial infarction (NSTEMI) in 113 patients (12.1%) and ST-elevation myocardial infarction (STEMI) in 381 patients (40.70%); 87 patients (9.29%) died during hospitalization and 193 (20.7%) developed complications. Predictors for in hospital mortality were as follows: red cell distribution width (RDW) (AUC 0.691, p < 0.0001), white blood cells (WBC) (AUC 0.684, p < 0.0001), neutrophils (NEU) (AUC 0.684, p < 0.0001), and prothrombin time (PT) (AUC 0.765, p < 0.0001). WBC (AUC 0.659, p < 0.0001), NEU (AUC 0.664, p < 0.0001), RDW (AUC 0.669, p < 0.0001), and PT (AUC 0.669, 95% CI 0.622–0.714, p < 0.0001) also had accuracy for complications prediction. RDW had a good ability to predict heart failure in NSTEMI patients (AUC 0.832, p < 0.0001). An acceptable ability to predict ventricular rhythm disturbances occurrence had WBC (AUC 0.758, p < 0.0001) and NEU (AUC 0.772, p < 0.0001). Hematological and coagulation parameters can help in risk stratification of ACS patients. RDW, WBC, NEU, and PT were able to predict mortality and in-hospital complications in ACS patients. RDW has a good accuracy in predicting complications and heart failure in NSTEMI patients. WBC and NEU are good predictors for ventricular rhythm disturbances.

The Effects of Different Hormones on Supraventricular and Ventricular Premature Contractions in Healthy Premenopausal Women

“…Apart from the well-established association between hyperthyroidism and atrial fibrillation, PACs have also been related to hyperthyroidism, whereas data about PVCs are limited and ventricular irritability has been linked mainly to hypothyroidism in several case reports [6,30,31]. In the same notion, the normal values of HbA1c in our cohort were not related to arrhythmias; high values of HbA1c in diabetes have been associated mainly with atrial fibrillation, apart from their already known role in the prediction of cardiovascular disease, together with other hematological and coagulation parameters [7,32,33]. However, cardiac autonomic neuropathy, which is mainly characterized by the generation of cardiac arrhythmias, is actually considered a form of diabetic neuropathy and involves a predominance of the sympathetic system and a concurrent damage to the parasympathetic system, which can eventually lead to hypertension and macrovascular complications [34].…”

Framing Cause-Effect Relationship of Acute Coronary Syndrome in Patients with Chronic Kidney Disease

“…A parenteral anticoagulant, aspirin and a P2Y12 inhibitor (dual antiplatelet therapy-DAPT) should be administered to patients who are referred to primary PCI [114]. To provide total suppression of thromboxane A2-dependent platelet aggregation, aspirin can be administered orally, also by chewing, or i.v.…”

Analysis of the Impact of Comorbidities on Endometrial Lesions Using the Charlson Comorbidity Index in Western Romania

“…Elderly women generally present EC, and adequate cancer therapy cannot be applied in many cases due to patients' multiple medical comorbidities [5,6]. Tolerance to treatment, as well as survival outcome in EC, is affected by advanced age, cardiovascular disorders, diabetes mellitus (DM), and other components of metabolic syndrome [7][8][9][10].…”