Prognostic value of hematological parameters in older adult patients with acute coronary syndrome undergoing coronary intervention: a single centre prospective study

BACKGROUND Cardiovascular disease is a significant contributor to the disease burden in geriatric patients. Underlying systemic inflammation is thought to be the cause of age-related changes in the bone marrow and a major risk factor for atherosclerosis.The purpose of the study was to assess the accuracy of these hematological biomarkers in predicting 30-day mortality in older patients with acute coronary syndrome(ACS).METHODS This was a prospective observational study of 601 older adult patients(age > 60 years) with ACS who underwent percutaneous coronary intervention over two years(2017–2019). The relationship between baseline hematological parameters and mortality was assessed during the 30-day follow-up. Logistic regression analysis and receiver operating characteristic curve analysis were done to evaluate for diagnostic accuracy of various hematological parameters.RESULTS The mean age of presentation was 77 ± 17 years. The mean neutrophil-lymphocyte ratio(NLR) value was 5.07 ± 4.90 and the mean platelet-lymphocyte ratio(PLR) value was 108.65 ± 85.82. On univariate analysis, total leucocyte count [odds ratio(OR) =0.85, P = 0.021], hematocrit(OR = 0.91, P = 0.018), NLR(OR = 1.10, P = 0.001) and PLR(OR = 1.05, P = 0.001) were associated with mortality. On receiver operating characteristic curve analysis, NLR predicted mortality with 68.1% and PLR with 65.7% accuracy. On multivariate analysis, NLR(OR = 1.096, 95% CI: 1.006–1.15, P = 0.035) was an independent predictor of 30-day mortality.CONCLUSIONS For the risk classification of all elderly ACS patients, we highly advise using NLR rather than the total white blood cell count.