摘要
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.
