NATIONAL SCIENTIFIC CENTER «INSTITUTE OF CARDIOLOGY NAMED AFTER ACAD. M.D. STRAZHESKA» NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE, KYIV, UKRAINE.
Wiad Lek. 2022;75(5 pt 2):1317-1322. doi: 10.36740/WLek202205216.
The aim: We have aimed to develop method of risk assessment in patients with acute STEMI using blood cells count useful in everyday clinical practice.
Materials and methods: 317 STEMI patients admitted to ICCU starting at 01/2014 to 06/2020 were included in this study. Data were evaluated partially retrospectively (n=214), 1st group) and prospectively, applying new risk-assessment tool in 103 patients 2nd group). Study groups did not differ in terms of all clinical characteristics.
Results: To evaluate criteria of severity of in-hospital complication we have created in-hospital complication index (HCI), composed according to number of adverse events per patient. Based on correlation analyses we have composed complex WBC-platelets (WBC-PLT) index = ((GRA - MON) / LYM) · 10 + PDWc + P-LCR). In the 1st study group WBC-PLT index was associated with in-hospital complications' index and correlated with neutrophil-leukocytes ratio (NLR) (p<0,001 and p<0,0005 respectively). WBC-PLT index > 137 appeared to be mildly associated with increased risk of adverse in-hospital outcomes (with specificity of 78 % and low sensitivity of 64 %, AUC- 0,72). Further prospective study of WBC-PLT index measured on the first STEMI-day (group 2) revealed that this parameter was more informative regarding association with adverse in-hospital events whereas NLR had low accuracy in risk assessment.
Conclusions: WBC-PLT index assessed on the first STEMI day may be used as a tool for detection of patients at risk of adverse in-hospital events in the every-day clinical practice.
我们旨在开发一种使用日常临床实践中有用的血细胞计数评估急性 STEMI 患者风险的方法。
这项研究纳入了 2014 年 1 月至 2020 年 6 月期间收入 ICCU 的 317 名 STEMI 患者。部分数据（n=214）进行了回顾性评估（第 1 组），其余 103 名患者前瞻性应用新的风险评估工具（第 2 组）。研究组在所有临床特征方面均无差异。
为了评估住院期间并发症严重程度的标准，我们创建了住院并发症指数（HCI），根据每位患者的不良事件数量构成。通过相关性分析，我们构成了复杂的白细胞血小板（WBC-PLT）指数=（（GRA-MON）/LYM）·10+PDWc+P-LCR）。在第 1 组研究中，WBC-PLT 指数与住院并发症指数相关，并与中性粒细胞-白细胞比（NLR）相关（p<0.001 和 p<0.0005）。WBC-PLT 指数>137 与不良住院结果的风险增加轻度相关（特异性为 78%，敏感性为 64%，AUC-0.72）。进一步对第 1 天 STEMI 时测量的 WBC-PLT 指数进行前瞻性研究（第 2 组）显示，该参数与不良住院事件的相关性更高，而 NLR 在风险评估中的准确性较低。
第 1 天 STEMI 时评估的 WBC-PLT 指数可作为一种工具，用于检测日常临床实践中处于不良住院事件风险中的患者。
