Sivri Serkan, Sokmen Erdogan, Celik Mustafa, Ozbek Sinan Cemgil, Yildirim Alp, Boduroglu Yalcin
Dr. Serkan Sivri, Department of Medicine, Ahi Evran University Training and Research Hospital, Kirsehir, Turkey.
Dr. Erdogan Sokmen, Department of Medicine, Ahi Evran University Training and Research Hospital, Kirsehir, Turkey.
Pak J Med Sci. 2019;35(3):824-829. doi: 10.12669/pjms.35.3.1017.
White blood cell (WBC) count to mean platelet volume (MPV) ratio (WMR) is associated with major adverse cardiovascular events in patients with non-ST elevation acute coronary syndrome (NSTEMI). We aimed to compare WMR between NSTEMI patients and matched-controls and to evaluate its predictive value on SYNTAX score.
Total 175 patients with NSTEMI and 160 age and co-morbidity matched subjects were recruited in our study. WMR was compared between the patient and control groups. The patient group was further subdivided into 3 tertiles according to SYNTAX scores as follows: low SYNTAX score tertile (score ≤22, 141 patients); intermediate SYNTAX score tertile (score between 23 and 32, 20 patients); and, high SYNTAX score tertile (score ≥33, 14 patients). WMR was further assessed among the tertiles.
WMR was significantly greater in the patient group compared to the control group (p<0,001). WMR among low, intermediate and high score tertiles were calculated to be 890±26, 1090±042 and 1500±65, respectively (p <0,001). In receiver operating characteristics (ROC) analysis, WMR >960 predicted a SYNTAX score ≥23 with 80.6% sensitivity and 67.6% specificity (AUC: 0.756; 95% CI: 0.685 - 0.818; p <0.0001) and a WMR >1360 predicted a SYNTAX score ≥33 with 71.4% sensitivity and 93% specificity (AUC: 0.840; 95%CI: 0.777 - 0.892; p <0.0001).
WMR value was significantly elevated in NSTEMI patients, compared to controls. Higher WMR was associated with greater SYNTAX score in patients with NSTEMI. WMR may be used to predict severity of the CAD and to implement risk stratification in patients with NSTEMI.
白细胞（WBC）计数与平均血小板体积（MPV）之比（WMR）与非ST段抬高型急性冠状动脉综合征（NSTEMI）患者的主要不良心血管事件相关。我们旨在比较NSTEMI患者与匹配对照组之间的WMR，并评估其对SYNTAX评分的预测价值。
本研究共纳入175例NSTEMI患者和160例年龄及合并症相匹配的受试者。比较患者组和对照组之间的WMR。患者组根据SYNTAX评分进一步分为3个三分位数，如下：低SYNTAX评分三分位数（评分≤22，141例患者）；中SYNTAX评分三分位数（评分在23至32之间，20例患者）；高SYNTAX评分三分位数（评分≥33，14例患者）。在这些三分位数中进一步评估WMR。
患者组的WMR显著高于对照组（p<0.001）。低、中、高评分三分位数的WMR分别计算为890±26、1090±42和1500±65（p<0.001）。在受试者工作特征（ROC）分析中，WMR>960预测SYNTAX评分≥23的敏感性为80.6%，特异性为67.6%（AUC：0.756；95%CI：0.685 - 0.818；p<0.0001），WMR>1360预测SYNTAX评分≥33的敏感性为71.4%，特异性为93%（AUC：0.840；95%CI：0.777 - 0.892；p<0.0001）。
与对照组相比，NSTEMI患者的WMR值显著升高。NSTEMI患者中较高的WMR与更高的SYNTAX评分相关。WMR可用于预测CAD的严重程度，并对NSTEMI患者进行风险分层。
