Table 1.
Summary of some studies investigating diagnostic and prognostic role of the most important hematological indices.
| Study type | Study | Sample size | Main findings | References |
|---|---|---|---|---|
| WBC | ||||
| Retrospective | Cannon et al. (2001) | 7651 patients with ACS | WBC count of >10,000 was associated with increased 30-day and 10-month mortality. | [9] |
| Retrospective | Barron et al. (2000) | 975 patients with MI | Elevation in WBC count was associated with reduced epicardial blood flow and myocardial perfusion, thromboresistance, and a higher incidence of new congestive heart failure and death. | [10] |
| Prospective | Sabatine et al. (2002) | 2220 patients with UA/NSTEMI | Higher baseline WBC count was associated with impaired epicardial and myocardial perfusion, more extensive CAD, and higher six-month mortality rates. | [8] |
| Retrospective | Gurm et al. (2003) | 4450 patients | A low or an elevated preprocedural WBC count in patients undergoing PCI is associated with an increased risk of long-term death. | [11] |
| Prospective | Chia et al. (2009) | 363 patients with STEMI | Elevated leucocyte and neutrophils are predictors of adverse cardiac events. | [12] |
| NLR | ||||
| Prospective | Duffy et al. (2006) | 1046 patients who underwent PCI | The NLR was an independent significant predictor of long-term mortality in patients who have undergone coronary angiography. | [18] |
| Prospective | Tamhane et al. (2008) | 2833 patients with ACS | NLR was a predictor of in-hospital and 6-month mortality in patients who undergo PCI. | [21] |
| Prospective | Núñez et al. (2008) | 515 patients with STEMI | NLR was a useful marker to predict subsequent mortality in patients admitted for STEMI, with a superior discriminative ability than total WBC. | [22] |
| Prospective | Azab et al. (2010) | 1345 patients with NSTEMI | NLR is an independent predictor of short-term and long-term mortalities in patients with NSTEMI. | [26] |
| Retrospective | Chatterjee et al. (2011) | 30,798 records who have undergone coronary angiography | A preprocedural NLR, elevated WBC count, and neutrophils were predictors of significant ventricular arrhythmias in patients undergoing PCI. | [27] |
| Prospective | Akpek et al. (2012) | 418 patients with STEMI who underwent PCI | The NLR was independently associated with the development of no-reflow and in-hospital MACEs in patients with ST-segment elevation myocardial infarction undergoing primary PCI. | [23] |
| Prospective | Sahin et al. (2013) | 840 patients with STEMI who underwent PCI | NLR was the independent predictor for SYNTAX score in patients with STEMI. | [24] |
| Retrospective | Sawant et al. (2014) | 250 consecutive STEMI patients | NLR based on an optimal cut-off value of 7.4 was an excellent predictor of short- and long-term survival in patients with revascularized STEMI. | [31] |
| Retrospective | Ayça et al. (2015) | 102 patients with stent tshrombosis and 450 patients with STEMI | In patients with STEMI, preprocedural high NLR was associated with both stent thrombosis and higher mortality rates. | [28] |
| Prospective | Yaylak et al. (2016) | A total of 213 subjects with inferior STEMI | NLR was an independent predictor of RVD in patients with inferior STEMI undergoing primary PCI. | [25] |
| RDW | ||||
| Retrospective | Nabais et al. (2009) | 1796 patients with ACS | There is a graded independent association between higher RDW values and adverse outcomes in patients with ACS. | [45] |
| Prospective | Lippi et al. (2009) | 456 patients with ACS | RDW at admission might be considered with other conventional cardiac markers for the risk stratification of ACS patients admitted to emergency departments. | [48] |
| Prospective | Dabbah et al. (2010) | 1709 patients with AMI | RDW is a predictor of mortality after AMI. Moreover, an increase in RDW during hospitalization also portends adverse clinical outcome. | [44] |
| Retrospective | Uyarel et al. (2011) | 2506 STEMI patients | RDW at admission was a predictor of in-hospital and long-term cardiovascular mortality. | [46] |
| Prospective | Isik et al. (2012) | 135 patients with STEMI | RDW is a marker indicating long-term prognosis. | [47] |
| Prospective | Timóteo et al. (2015) | 787 patients with ACS | Combination of RDW with GRACE score improves the predictive value for all-cause mortality. | [80] |
| PLR | ||||
| Observational study | Azab et al. (2012) | 619 patients with NSTEMI | PLR is a significant independent predictor of long-term mortality after NSTEMI. | [56] |
| Prospective | Kurtul et al. (2014) | 1016 patients with ACS | PLR at admission is significantly associated with the severity and complexity of coronary atherosclerosis in patients with ACS. Increased PLR is an independent predictor of higher SYNTAX score in patients with ACS who undergo urgent CA. |
[82] |
| Retrospective | Acet et al. (2016) | 800 patients with STEMI | PLR, RDW and monocyte were associated with GRACE score in patients with STEMI. | [81] |
| Retrospective | Yildiz et al. (2015) | 287 patients with STEMI | High preprocedural PLR and NLR levels are significant and independent predictors of no-reflow in patients undergoing primary PCI. | [58] |
| Prospective | Sun et al. (2017) | 5886 patients with STEMI | Higher PLR was associated with recurrent myocardial infarction, heart failure, ischemic stroke, and all-cause mortality in patients with STEMI. | [57] |
| Prospective | Vakili et al. (2017) | 215 patients with STEMI | PLR and NLR were associated with no-reflow phenomenon in patients with STEMI treated with pPCI. | [59] |
| PDW | ||||
| Prospective | De Luca et al. (2010) | 1882 patients undergoing coronary angiography + IMT in 359 patients | PDW is not related to the extent of CAD and carotid IMT. PDW positively correlated with age, weight, waist circumference, and prevalence of diabetes. | [78] |
| Prospective | Rechciński et al. (2013) | 538 patients who underwent primary PCI in acute MI | PDW and P-LCR are prognostic predictors after MI. | [63] |
| Retrospective | Celik et al. (2015) | 306 patients with STEMI | Baseline PDW and MPV are independent correlates of no-reflow and in-hospital MACEs among patients with STEMI undergoing pPCI. | [64] |
| Retrospective | Bekler et al. (2015) | 502 patients with ACS were enrolled. | The group with PDW > 17% had significantly higher Gensini score. | [61] |
| MPV | ||||
| Prospective | Huczek et al. (2005) | 398 patients with STEMI | MPV is a predictor of impaired reperfusion and mortality in STEMI treated with pPCI. | [65] |
| Case-control study | Huczek et al. (2010) | 36 consecutive ST cases and 72 matched controls | Baseline platelet size is increased in patients with ACS developing early stent thrombosis and correlates with future residual platelet reactivity. | [70] |
| Systematic review + meta-analisis | Chu et al. 2010 | Pooled results from 16 cross-sectional studies involving 2809 patients with CAD | Elevated MPV is associated with AMI, mortality following myocardial infarction, and restenosis following coronary angioplasty. | [69] |
| Retrospective | Isik et al. (2012) | 2467 who underwent coronarography with CAD | Diabetes, smoking, hemoglobin, and MPV were found to be the independent correlates of SCF presence. Moreover, only MPV was identified as an independent correlate of extent of SCF. | [73] |
| Prospective | Wan et al. (2014) | 297 ACS patients | Both MPV and the GRACE score were significant and independent predictors for CVD events. Combination of MPV with the scoring system improved the predictive value. |
[83] |
| Prospective | Niu et al. (2015) | 506 ACS patients | Elevated MPV was an independent predictor of 6-month mortality or MI in patients with ACS. The addition of MPV to the GRACE model improved its predictive value. |
[84] |
ACS: acute coronary syndrome; AMI: acute myocardial infarction; NSTEMI: non-ST elevation myocardial infarction; MI: myocardial infarction; MPV: mean platelet volume; STEMI: ST elevation myocardial infarction; CAD: coronary artery disease; TIMI: thrombolysis in myocardial infarction; WBC: white blood cell count; RDW: red blood cell distribution width; PDW: platelet distribution width; PLR: platelet lymphocyte ratio; P-LCR: platelet large cell ratio; CVD: cardiovascular disease; HF: heart failure; PCI: percutaneous coronary intervention; RVD: right ventricular dysfunction; MACEs: major adverse cardiac events; GRACE: global registry of acute coronary events; SCF: slow coronary flow; IMT: intima media thickness.