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

Affiliations
  • 1Department of Cardiology, Urmia University of Medical Sciences, Urmia, Iran.
  • 2Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran. yousefrezaei1986@gmail.com
  • 3School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.

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

  • 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.

  • 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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