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

Elena Emilia Babes; Dana Carmen Zaha; Delia Mirela Tit; Aurelia Cristina Nechifor; Simona Bungau; Felicia Liana Andronie-Cioara; Tapan Behl; Manuela Stoicescu; Mihai Alexandru Munteanu; Marius Rus; Mirela Marioara Toma; Ciprian Brisc

doi:10.3390/diagnostics11050850

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

Diagnostics (Basel). 2021 May 9;11(5):850. doi: 10.3390/diagnostics11050850.

Authors

Elena Emilia Babes^{1

2}, Dana Carmen Zaha^{2

3}, Delia Mirela Tit^{4

5}, Aurelia Cristina Nechifor⁶, Simona Bungau^{4

5}, Felicia Liana Andronie-Cioara⁷, Tapan Behl⁸, Manuela Stoicescu^{1

2}, Mihai Alexandru Munteanu^{1

2}, Marius Rus^{1

2}, Mirela Marioara Toma^{4

5}, Ciprian Brisc^{1

2}

Affiliations

¹ Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania.
² Clinical Emergency Hospital of Oradea, 410169 Oradea, Romania.
³ Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy of Oradea, University of Oradea, 410073 Oradea, Romania.
⁴ Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania.
⁵ Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania.
⁶ Analytical Chemistry and Environmental Engineering Department, Polytechnic University of Bucharest, 011061 Bucharest, Romania.
⁷ Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania.
⁸ Department of Pharmacology, Chitkara College of Pharmacy, Chitkara University, Punjab 140401, India.

Abstract

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.

Keywords: acute coronary syndromes; adverse events; coagulation parameters; hematological parameters; prognostic factors.