White Blood Cell Count to Mean Platelet Volume Ratio Is a Prognostic Factor in Patients with Non-ST Elevation Acute Coronary Syndrome with or without Metabolic Syndrome

Abstract

Background and ObjectivesLeukocyte and platelet have been found to be associated with metabolic syndrome (MetS). We aimed to determine the usefulness of a novel marker named white blood cell count to mean platelet volume ratio (WMR) for predicting outcomes of non-ST elevation acute coronary syndrome (NSTE-ACS) with or without MetS.Subjects and MethodsA total of 331 NSTE-ACS individuals (60±12.5 years, 57.4% male) were enrolled and followed for a median of 24 months. MetS was identified using the National Cholesterol Education Program Adult Treatment Panel III criteria.ResultsPatients were divided into two groups: high WMR (WMR≥720) and low WMR (WMR<720). Major adverse cardiovascular events (MACE) and MetS rates were significantly greater in the higher WMR group compared to those in the low WMR group (MACE: 14.3% vs. 25%, p=0.014; MetS: 50.9% vs. 75%, p<0.001). MetS was diagnosed in 62.2% of patients. MACE incidence in patients with or without MetS was comparable (p=0.737). Among MetS individuals, patients in the high WMR group had more MACE than the low WMR group (11.2% vs. 26.5%, p=0.007). However, MACE was comparable among non-MetS individuals (p=0.681). In multivariable Cox regression analysis, hazard ratios (HR) of MACE incidence for high-WMR in MetS individuals was 2.616 (95% confidence interval: 1.282–5.339, p=0.008). However, HR of MACE incidence for high WMR in non-MetS individuals was not significant.ConclusionAmong NSTE-ACS patients without revascularization therapy, elevated admission WMR was associated with an increased risk of developing composite MACE in MetS individuals but not in non-MetS patients.

Maternal peripheral blood platelet‐to‐white blood cell ratio and platelet count as potential diagnostic markers of histological chorioamnionitis‐related spontaneous preterm birth

“…It was estimated that about 40% of cases of preterm birth have been correlated with intrauterine infection . Infection induced inflammatory condition that involves the recruitment of leukocytes, including neutrophils, monocytes, and lymphocytes; thus, increased number of immune cells in the peripheral blood may indicate the progress of the infectious disease . In the present study, the neutrophil count and WBC count of control, non‐HCA patients, and HCA patients were compared.…”

“…Some previous studies demonstrated that neutrophil‐to‐lymphocyte ratio of the patients was associated with the diagnosis and outcome of different diseases, including acute cerebrovascular diseases . On the other hand, the neutrophil‐to‐white blood cell ratio (NE/WBC) or platelet‐to‐white blood cell ratio (PLT/WBC) was significantly increased in patients with different type of diseases, for example, cancer, cardiovascular disease, and autoimmune diseases, suggesting that either NE/WBC or PLT/WBC may serve as novel biomarkers for the early diagnosis of those diseases …”

Subclinical systolic and diastolic dysfunctions in patients with metabolic syndrome and angiographically normal coronary arteries: An echocardiographic study

“…The metabolic syndrome (MetS) is a cluster of major cardiovascular risk factors including fasting hyperglycemia, hypertriglyceridemia, low high‐density lipoprotein, abdominal obesity, and systemic arterial hypertension . Among its diagnostic criteria, those of the National Cholesterol Education Program Adult Treatment Panel III (NCEP‐ATP III) are the most often used .…”

Complete blood cell count components and coronary slow-flow phenomenon

“…All these novel biomarkers are inflammation-based and have been useful in diagnosing other inflammatory diseases. White blood cell to mean platelet volume ratio is another novel biomarker examined in coronary artery disease and metabolic syndrome,19,20 which may be useful to detect the presence of CSFP as well.…”