Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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White Blood Cell Count to Mean Platelet Volume Ratio Is a Prognostic Factor in Patients with Non-ST Elevation Acute Coronary Syndrome with or without Metabolic Syndrome

  • Dehghani, Mohammad Reza (Department of Cardiology, Urmia University of Medical Sciences) ;
  • Rezaei, Yousef (Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences) ;
  • Fakour, Sanam (School of Medicine, Urmia University of Medical Sciences) ;
  • Arjmand, Nasim (School of Medicine, Urmia University of Medical Sciences)
  • Received : 2015.06.02
  • Accepted : 2015.08.11
  • Published : 2016.03.30
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Abstract

Background and Objectives: Leukocyte and platelet have been found to be associated with metabolic syndrome (MetS). We aimed to determine the usefulness of a novel marker named white blood cell count to mean platelet volume ratio (WMR) for predicting outcomes of non-ST elevation acute coronary syndrome (NSTE-ACS) with or without MetS. Subjects and Methods: A total of 331 NSTE-ACS individuals ($60{\pm}12.5years$, 57.4% male) were enrolled and followed for a median of 24 months. MetS was identified using the National Cholesterol Education Program Adult Treatment Panel III criteria. Results: Patients were divided into two groups: high WMR ($WMR{\geq}720$) and low WMR (WMR<720). Major adverse cardiovascular events (MACE) and MetS rates were significantly greater in the higher WMR group compared to those in the low WMR group (MACE: 14.3% vs. 25%, p=0.014; MetS: 50.9% vs. 75%, p<0.001). MetS was diagnosed in 62.2% of patients. MACE incidence in patients with or without MetS was comparable (p=0.737). Among MetS individuals, patients in the high WMR group had more MACE than the low WMR group (11.2% vs. 26.5%, p=0.007). However, MACE was comparable among non-MetS individuals (p=0.681). In multivariable Cox regression analysis, hazard ratios (HR) of MACE incidence for high-WMR in MetS individuals was 2.616 (95% confidence interval: 1.282-5.339, p=0.008). However, HR of MACE incidence for high WMR in non-MetS individuals was not significant. Conclusion: Among NSTE-ACS patients without revascularization therapy, elevated admission WMR was associated with an increased risk of developing composite MACE in MetS individuals but not in non-MetS patients.

Keywords

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