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

• Published in: Diagnostics (Basel) Vol. 11; no. 5; p. 850
• Main Authors: Babes, Elena Emilia, Zaha, Dana Carmen, Tit, Delia Mirela, Nechifor, Aurelia Cristina, Bungau, Simona, Andronie-Cioara, Felicia Liana, Behl, Tapan, Stoicescu, Manuela, Munteanu, Mihai Alexandru, Rus, Marius, Toma, Mirela Marioara, Brisc, Ciprian
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 09.05.2021; MDPI
• Subjects: Acute coronary syndromes; adverse events; Angina pectoris; Atherosclerosis; Biomarkers; Blood; Cardiac arrhythmia; Cardiovascular disease; coagulation parameters; Coronary vessels; Ejection fraction; Heart attacks; Heart failure; hematological parameters; Hematology; Hospitals; Inflammation; Ischemia; Medical prognosis; Mortality; prognostic factors; Regression analysis; Thrombosis; Variables; Romania; prognostic factors; adverse events; coagulation parameters; acute coronary syndromes; hematological parameters
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics11050850

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.