A New Perspective on NSTE-ACS Patients in the Emergency Department: Cardiac Risk Prediction with New Inflammation Markers.

BACKGROUND Acute coronary syndromes (ACS) remains a leading cause of death worldwide. The use of inflammation biomarkers has recently become quite popular in understanding both the severity and prognosis of cardiovascular diseases. The aim of this study was to investigate the association of pan-immune-inflammation value (PIV) with the risk of in-hospital MACE assessed by the GRACE risk score (GRS) in patients diagnosed with NSTE-ACS. MATERIAL AND METHODS A total of 489 patients were admitted to the Emergency Department (ED) of our hospital with chest pain and hospitalized in the coronary intensive care unit and diagnosed with NSTE-ACS. PIV was calculated as: neutrophil count times platelet count times monocyte count divided by lymphocyte count. RESULTS Of the patients included in this study, 91 (18.6%) had low GRS, 183 (37.4%) had intermediate GRS, and 215 (44%) had high GRS. The inflammatory markers PIV, SII, and NLR were found to be statistically significantly higher in the MACE (+) groups (P<0.001). ROC curve analysis showed 82% sensitivity and 84% specificity in detecting MACE for a cut-off value of 756.03 for PIV (area under the receiver operating characteristics [ROC] curve 0.86 [95% CI: 0.82-0.89], P<0.001). CONCLUSIONS Inflammatory markers such as PIV were found to be statistically significantly higher in the MACE (+) groups of NSTE-ACS patients. Moreover, there was a statistically significant correlation between PIV value and GRS.