Usefulness of WBC Count to Mean Platelet Volume Ratio in Predicting Short-Term (30 Days) Major Adverse Cardiac Events in Patients Presenting with Acute Coronary Syndrome and its Comparison in Males and Females

Abstract

Abstract Background: Among cardiovascular illnesses, acute coronary syndrome (ACS) events are associated with higher mortality and morbidity. The mechanism of inflammation involved in the ACS includes atherosclerotic plaque development, followed by development of plaque rupture and thrombosis. The present study is to determine whether white blood cell count to mean platelet volume ratio (WMR) can predict short-term (30 days) major adverse cardiac events (MACE) in ACS patients, and also compare WMR and MACE in males and females. Aim: To detect usefulness of white blood cell (WBC) count to WMR in predicting short term (30 days) MACE in patients presenting with ACS and compare values and MACE events in males and females. Material and Methods: The present study was conducted in a tertiary-care hospital from September 2020 to December 2020. A total of 60 patients, who presented with ACS and were undergoing percutaneous coronary intervention (PCI), fulfilled the selection criterion; hence, a total of 60 patients were selected for the study after taking informed consent. The clearance from the Institutional Ethical committee (IEC) was obtained prior to the initiation of the study. All the necessary investigations were done in patients who fulfilled the inclusion criteria. The results of the study were systematically selected and analysis done statistically. The study included all patients with clinical suspicion of ACS for more than 18 years and excluded non-ACS patients, patients with malignancy history, inflammatory diseases, autoimmune disorders, infections, and those who are immunosuppressed. Results: In the present study, receiver operating characteristic (ROC) curve showed cutoff value of WMR as 1059 with area under curve (AUC) of 0.6 (95% CI 0.4–0.9). MACE occurred in 12 patients and mortality occurred in 6 patients. Among MACE, recurrent myocardial infarction (REMI) occurred in 7 (35%) cases, arrhythmias occurred in 5 (25%), and cardiogenic shock occurred in 8 (40%) cases. WMR with a cutoff value of 1059 was significant and highly accurate in predicting MACE, with sensitivity of 91.6%, specificity of 87.5%, PPV of 64.7%, NPV of 97.6%, and diagnostic accuracy of 88.3%. Compared to males, females have less sensitivity to, high specificity to, and high diagnostic accuracy of WMR ratio in predicting MACE. MACE did not show any gender predilection. Conclusion: In patients, who presented with ACS, high WMR values were associated with worse short-term outcomes and independently predicted short-term MACE. Compared to males, females have less sensitivity to, high specificity to, and high diagnostic accuracy of WMR ratio in predicting MACE.