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White blood cell count to mean platelet volume ratio as a novel non-invasive marker predicting long-term outcomes in patients with non-ST elevation acute coronary syndrome
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Abstract
Background: Total white blood cell (WBC) count and mean platelet volume have previously been shown to predict outcomes in acute coronary syndrome (ACS) patients. In this prospective study, we sought to determine the prognostic value of baseline WBC count to mean platelet volume ratio (WMR) in patients with non-ST elevation acute coronary syndrome (NSTE-ACS).
Methods: A total of 490 patients with NSTE-ACS were prospectively enrolled. The relationship between baseline WMR and major adverse cardiovascular events (MACE) incidence was assessed during a mean follow-up of 330.8 ± 38 days.
Results: The patients’ mean age was 60.4 ± 12.9 year, 59% of them were male. The patients were categorized into two groups based on WMR values, high- and low-WMR groups (< 755 vs. ≥ 755). The incidence of MACE was significantly higher in high-WMR compared with that of low-WMR group (22.4% vs. 10.7%, p < 0.001). Total WBC counts (median 7.9 vs. 6.9 ×103/μL, p = 0.004), neutrophil count (median 4.6 vs. 4.2 ×103/μL, p = 0.021), and WMR (median 863.2 vs. 731.5, p = 0.001) were significantly higher in the MACE-positive than MACE-negative group. The high-WMR was found to be significantly associated with the MACE-free survival rate (p < 0.001). In an adjusted cox regression model, the elevated WMR was independently predicted the incidence of MACE (hazard ratio 2.419, 95% CI 1.515–3.862, p < 0.001).
Conclusions: The elevated baseline WMR independently predicted the MACE incidence in patients with NSTE-ACS during long-term follow-up.
Abstract
Background: Total white blood cell (WBC) count and mean platelet volume have previously been shown to predict outcomes in acute coronary syndrome (ACS) patients. In this prospective study, we sought to determine the prognostic value of baseline WBC count to mean platelet volume ratio (WMR) in patients with non-ST elevation acute coronary syndrome (NSTE-ACS).
Methods: A total of 490 patients with NSTE-ACS were prospectively enrolled. The relationship between baseline WMR and major adverse cardiovascular events (MACE) incidence was assessed during a mean follow-up of 330.8 ± 38 days.
Results: The patients’ mean age was 60.4 ± 12.9 year, 59% of them were male. The patients were categorized into two groups based on WMR values, high- and low-WMR groups (< 755 vs. ≥ 755). The incidence of MACE was significantly higher in high-WMR compared with that of low-WMR group (22.4% vs. 10.7%, p < 0.001). Total WBC counts (median 7.9 vs. 6.9 ×103/μL, p = 0.004), neutrophil count (median 4.6 vs. 4.2 ×103/μL, p = 0.021), and WMR (median 863.2 vs. 731.5, p = 0.001) were significantly higher in the MACE-positive than MACE-negative group. The high-WMR was found to be significantly associated with the MACE-free survival rate (p < 0.001). In an adjusted cox regression model, the elevated WMR was independently predicted the incidence of MACE (hazard ratio 2.419, 95% CI 1.515–3.862, p < 0.001).
Conclusions: The elevated baseline WMR independently predicted the MACE incidence in patients with NSTE-ACS during long-term follow-up.
Keywords
white blood cell to mean platelet volume ratio, non-ST elevation acute coronary syndrome, major adverse cardiovascular events


Title
White blood cell count to mean platelet volume ratio as a novel non-invasive marker predicting long-term outcomes in patients with non-ST elevation acute coronary syndrome
Journal
Issue
Pages
437-445
Published online
2015-08-28
Page views
4696
Article views/downloads
2124
DOI
10.5603/CJ.a2015.0015
Pubmed
Bibliographic record
Cardiol J 2015;22(4):437-445.
Keywords
white blood cell to mean platelet volume ratio
non-ST elevation acute coronary syndrome
major adverse cardiovascular events
Authors
Mohammad Reza Dehghani
Yousef Rezaei
Leila Taghipour-Sani