The Role of Hematological Indices in Patients with Acute Coronary Syndrome

Overview

Journal Dis Markers

Publisher Wiley

Specialty Biochemistry

Date 2017 Nov 8

PMID 29109595

Citations 72

Authors

Jan Budzianowski

Konrad Pieszko

Pawel Burchardt

Janusz Rzezniczak

Jaroslaw Hiczkiewicz

Affiliations

Soon will be listed here.

Abstract

An increased systemic and local inflammation plays a key role in the pathophysiology of acute coronary syndrome (ACS). This review will discuss the role of hematological indices: white blood cells (WBC), neutrophil to lymphocyte ratio (NLR), red cell distribution width (RDW), and platelet indices, that is, platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet distribution width (PDW) in the case of ACS. In recent years, a strong interest has been drawn to these indices, given that they may provide independent information on pathophysiology, risk stratification, and optimal management. Their low-cost and consequent wide and easy availability in daily clinical practice have made them very popular in the laboratory testing. Furthermore, many studies have pointed at their effective prognostic value in all-cause mortality, major cardiovascular events, stent thrombosis, arrhythmias, and myocardial perfusion disorders in terms of acute myocardial infarction and unstable angina. The most recent research also emphasizes their significant value in the combined analysis with other markers, such as troponin, or with GRACE, SYNTAX, and TIMI scores, which improve risk stratification and diagnosis in ACS patients.

Citing Articles

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References

Niu X, Yang C, Zhang Y, Zhang H, Yao Y . Mean platelet volume on admission improves risk prediction in patients with acute coronary syndromes. Angiology. 2014; 66(5):456-63. DOI: 10.1177/0003319714536024. View

Timoteo A, Papoila A, Lousinha A, Alves M, Miranda F, Ferreira M . Predictive impact on medium-term mortality of hematological parameters in Acute Coronary Syndromes: added value on top of GRACE risk score. Eur Heart J Acute Cardiovasc Care. 2014; 4(2):172-9. DOI: 10.1177/2048872614547690. View

Barron H, Cannon C, Murphy S, Braunwald E, Gibson C . Association between white blood cell count, epicardial blood flow, myocardial perfusion, and clinical outcomes in the setting of acute myocardial infarction: a thrombolysis in myocardial infarction 10 substudy. Circulation. 2000; 102(19):2329-34. DOI: 10.1161/01.cir.102.19.2329. View

Dutta P, Courties G, Wei Y, Leuschner F, Gorbatov R, Robbins C . Myocardial infarction accelerates atherosclerosis. Nature. 2012; 487(7407):325-9. PMC: 3401326. DOI: 10.1038/nature11260. View

Sun X, Li J, Zhu W, Li D, Chen H, Li H . Impact of Platelet-to-Lymphocyte Ratio on Clinical Outcomes in Patients With ST-Segment Elevation Myocardial Infarction. Angiology. 2016; 68(4):346-353. DOI: 10.1177/0003319716657258. View

Ensrud K, Grimm Jr R . The white blood cell count and risk for coronary heart disease. Am Heart J. 1992; 124(1):207-13. DOI: 10.1016/0002-8703(92)90942-o. View

Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I . Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia. 2010; 14(1):28-32. PMC: 2843567. View

Wang X, Zhang G, Jiang X, Zhu H, Lu Z, Xu L . Neutrophil to lymphocyte ratio in relation to risk of all-cause mortality and cardiovascular events among patients undergoing angiography or cardiac revascularization: a meta-analysis of observational studies. Atherosclerosis. 2014; 234(1):206-13. DOI: 10.1016/j.atherosclerosis.2014.03.003. View

Asher V, Lee J, Innamaa A, Bali A . Preoperative platelet lymphocyte ratio as an independent prognostic marker in ovarian cancer. Clin Transl Oncol. 2011; 13(7):499-503. DOI: 10.1007/s12094-011-0687-9. View

10.

Tamhane U, Aneja S, Montgomery D, Rogers E, Eagle K, Gurm H . Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol. 2008; 102(6):653-7. DOI: 10.1016/j.amjcard.2008.05.006. View

11.

Wan Z, Zhou D, Xue J, Wu Y, Wang H, Zhao Y . Combination of mean platelet volume and the GRACE risk score better predicts future cardiovascular events in patients with acute coronary syndrome. Platelets. 2013; 25(6):447-51. DOI: 10.3109/09537104.2013.830708. View

12.

Yaylak B, Ede H, Baysal E, Altintas B, Akyuz S, Sevuk U . Neutrophil/lymphocyte ratio is associated with right ventricular dysfunction in patients with acute inferior ST-segment elevation myocardial infarction. Cardiol J. 2015; 23(1):100-6. DOI: 10.5603/CJ.a2015.0061. View

13.

Estevez-Loureiro R, Salgado-Fernandez J, Marzoa-Rivas R, Barge-Caballero E, Perez-Perez A, Noriega-Concepcion V . Mean platelet volume predicts patency of the infarct-related artery before mechanical reperfusion and short-term mortality in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Thromb Res. 2009; 124(5):536-40. DOI: 10.1016/j.thromres.2009.03.012. View

14.

Azab B, Shah N, Akerman M, McGinn Jr J . Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-ST-elevation myocardial infarction. J Thromb Thrombolysis. 2012; 34(3):326-34. DOI: 10.1007/s11239-012-0718-6. View

15.

Felker G, Allen L, Pocock S, Shaw L, McMurray J, Pfeffer M . Red cell distribution width as a novel prognostic marker in heart failure: data from the CHARM Program and the Duke Databank. J Am Coll Cardiol. 2007; 50(1):40-7. DOI: 10.1016/j.jacc.2007.02.067. View

16.

Azab B, Zaher M, Weiserbs K, Torbey E, Lacossiere K, Gaddam S . Usefulness of neutrophil to lymphocyte ratio in predicting short- and long-term mortality after non-ST-elevation myocardial infarction. Am J Cardiol. 2010; 106(4):470-6. DOI: 10.1016/j.amjcard.2010.03.062. View

17.

Hampole C, Mehrotra A, Thenappan T, Gomberg-Maitland M, Shah S . Usefulness of red cell distribution width as a prognostic marker in pulmonary hypertension. Am J Cardiol. 2009; 104(6):868-72. DOI: 10.1016/j.amjcard.2009.05.016. View

18.

Yarnell J, Baker I, Sweetnam P, Bainton D, OBrien J, Whitehead P . Fibrinogen, viscosity, and white blood cell count are major risk factors for ischemic heart disease. The Caerphilly and Speedwell collaborative heart disease studies. Circulation. 1991; 83(3):836-44. DOI: 10.1161/01.cir.83.3.836. View

19.

Nabais S, Losa N, Gaspar A, Rocha S, Costa J, Azevedo P . Association between red blood cell distribution width and outcomes at six months in patients with acute coronary syndromes. Rev Port Cardiol. 2009; 28(9):905-24. View

20.

Floyd C, Ferro A . Mechanisms of aspirin resistance. Pharmacol Ther. 2013; 141(1):69-78. DOI: 10.1016/j.pharmthera.2013.08.005. View