Korean Circ J.  2016 Mar;46(2):229-238. 10.4070/kcj.2016.46.2.229.

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

• Dehghani M
• Rezaei Y
• Fakour S
• Arjmand N

• KMID: 2344475
• DOI: http://doi.org/10.4070/kcj.2016.46.2.229

Abstract

BACKGROUND AND OBJECTIVES
Leukocyte 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 METHODS
A 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.
RESULTS
Patients 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.
CONCLUSION
Among 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.

Keyword

White blood cell count; Mean platelet volume; Acute coronary syndrome; Metabolic syndrome; Inflammation

MeSH Terms

Acute Coronary Syndrome*
Adult
Blood Platelets*
Cholesterol
Education
Humans
Incidence
Inflammation
Leukocyte Count*
Leukocytes*
Mean Platelet Volume
Cholesterol

Figure

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  Fig. 1 Kaplan-Meier curve analysis showing the estimated proportion of patients remaining free of MACE incidence during follow-up in MetS vs. non-MetS individuals. MACE: major adverse cardiac events, MetS: metabolic syndrome.

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  Fig. 2 Kaplan-Meier curve analyses showing the estimated proportion of patients remaining free of MACE incidence during follow-up within (A) all patients together, (B) patients with MetS, and (C) patients without MetS. MACE: major adverse cardiac events, MetS: metabolic syndrome, WMR: white blood cell count to mean platelet volume ratio.

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