DIAGNOSTIC UTILITY OF LEUKOCYTE PARAMETERS IN THE PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Abstract

Background. Inflammation is one of the key players in acute myocardial infarction (AMI). One of the ways to evaluate it indirectly is to analyze leukocyte parameters of complete blood count (CBC), which is a routine and affordable method of diagnosis. Leukocyte counts can provide additional information about the course, as well as a potential prognosis for complications of AMI. We suggest that the dynamic changes of CBC during the treatment of the patients with AMI may be of value to assess the prognosis of the course of the disease, and therefore require further study. Objective. The aim of the study to evaluate the diagnostic and prognostic potential of leukocyte indexes of CBC, in particular the levels of leukocytes, lymphocytes, neutrophils and N/L, WBC/MPV, PLT/L ratios in the patients with AMI at the time of hospitalization and on the 7th day of hospital stay. Methods. The study involved 204 individuals: 152 patients with AMI (Group 1), 30 patients with stable coronary heart disease (Group 2) and 24 healthy volunteers (Group 3). Hemogram parameters and their ratios, in particular the levels of leukocytes, lymphocytes, neutrophils, ESR, as well as the ratios of N/L and PLT/L were studied. Results. Levels of leukocytes, neutrophils, lymphocytes, as well as N/L, WBC/MPV, MPV/L ratios were significantly higher in the patients with AMI compared to other groups. The best diagnostic value had such indicators as the total number of leukocytes (sensitivity 71.7%, specificity 69.7%, AUC 0.794), the absolute number of granulocytes (sensitivity 81.7%, specificity 77.4%, AUC 0.803), the N/L ratio (sensitivity 75.0%, specificity 71.7%, AUC 0.791) and the WBC/MPV ratio (sensitivity 76.7%, specificity 62.3%, AUC 0.760). The PLT/L ratio calculated on the 7th day of hospital stay correlated with the risk of in-hospital (r=0.369, p=0.002) and 6-month mortality (r=0.338, p=0.004) according to the GRACE score. Conclusions. Leukocytes, granulocytes, N/L and WBC/MPV ratios had a fairly high diagnostic value for the patients with AMI. Regarding the prognostic potential assessment, only the PLT/L ratio on the 7th day of hospitalization correlated with the risk of in-hospital and 6-month mortality. This proves the importance of assessing CBC parameters not only at the time of hospitalization, but also in the dynamics of AMI.