Correlation between Inflammatory and Hematologic Biomarkers and Cardiovascular Outcomes Among CCU and Post-CCU Patients Diagnosed with Acute Coronary Syndrome: A Retrospective Study

Sayed Mohammed Jawad Alwedaie; Yazdan Baser; Nazanin Alibeik; Alireza Javan; Nasim Torabi; Ramin Bozorgmehr; Milad Shemshadi; Faria Rostamkolaei; Meysam Abolmaali; Neda Rahimian

doi:10.18502/jimc.v6i4.13441

Sayed Mohammed Jawad Alwedaie Royal College of Surgeons in Ireland-Medical University of Bahrain, Bahrain
Yazdan Baser Department of Medical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Nazanin Alibeik Department of Internal Medicine, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Alireza Javan Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Nasim Torabi Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
Ramin Bozorgmehr Department of General Surgery, Shahid Madani Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
Milad Shemshadi Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Faria Rostamkolaei Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Meysam Abolmaali Shefa Neuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran
Neda Rahimian Department of Medical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v6i4.13441

Keywords: Acute coronary syndrome, C-Reactive protein, Humans, Neutrophils, Pro-brain natriuretic peptide (1-76), Prognosis, Troponin

Abstract

Background: Deaths associated with the Acute Coronary Syndrome (ACS) remain high among Cardiac/Coronary Care Unit (CCU) and post-CCU patients. Recently, researchers have looked for inexpensive and reliable prognostic indicators as alternatives to the expensive pro-Brain Natriuretic Peptide (proBNP) in ACS patients to predict adverse outcomes.

Methods: We retrieved the Complete Blood Count (CBC) records of ACS patients and calculated values for plateletcrit (PCT), Mean Platelet Volume (MPV), and Neutrophil-to-Lymphocyte Ratio (NLR). We also recorded ACS diagnostic methods, duration of hospital stays (CCU and post-CCU), and therapeutic modalities. We considered outcomes such as death, positive or negative troponin, ST-elevation, ejection fraction <45, and history of arrhythmia.

Results: The multivariate model using forward stepwise logistic regression showed that the history of arrhythmia (OR=124.052, p= 0.001), positive troponin (OR=47.545, p=0.002), hospitalization period (OR=2.376, p=0.001), C-reactive protein (CRP) (OR=1.359, p=0.001), and PCT (OR=2.018, p=0.001) are independent predictors of mortality.

Conclusion: CRP and PCT are considered independent predictors of mortality among CCU and post-CCU patients diagnosed with ACS. However, the prognostic significance of NLR and MPV needs to be confirmed by further investigations.