Predictive value of atherosclerotic index of plasma, white blood cells count and neutrophil lymphocyte ratio in acute coronary syndrome

Abstract:

Objective To investigate the predictive value of atherosclerotic index of plasma（AIP）， white blood cells（WBC） count and neutrophil lymphocyte ratio（NLR） to acute coronary syndrome（ACS） and the severity of coronary lesions.Methods Patients with suspected coronary heart disease who first visited the hospital from January 2019 to December 2021 were retrospectively enrolled. All patients were divided into two groups，ACS group（n=288） and non-ACS group（n=93）. The receiver operating characteristic （ROC） curve and multivariate logistic regression were used to analyze the predictive value of AIP， WBC count and NLR in ACS. Spearman rank correlation was used to analyze the correlation between the indexes and Gensini score.Results AIP， WBC count and NLR in ACS group were significantly higher than those in non-ACS group（t/Z=3.623，6.697，-6.165，P<0.001）. Logistic regression analysis showed that AIP，WBC count and NLR were independent risk factors for ACS. After excluding confounding factors， with the increase of each additional unit of AIP，WBC and NLR，the risk of ACS increased by 6.739 times（95%CI=2.829-21.169，P<0.001），0.260 times（95%CI=1.113-1.426，P<0.001），and 0.145 times（95%CI=1.036-1.265，P=0.008）. The area under the curve（AUC） for predicting ACS with AIP，WBC count and NLR was 0.627（95%CI=0.563-0.692，P<0.001），0.696（95%CI=0.638-0.755，P<0.001），and 0.713（95%CI=0.652-0.773，P<0.001），respectively. The larger AUC of 0.756（95%CI=0.700-0.813，P<0.001） was observed when the combination of the three indicators was used to predict ACS. The proportions of complete vascular occlusion，left main coronary artery or multiple vascular branch lesions and Gensini score in high AIP， high WBC and high NLR groups were significantly higher than those in low value groups（all P<0.05）. The three indicators were significantly positively correlated with Gensini score（r=0.188，0.313， 0.332，all P<0.001）.Conclusion AIP，WBC count and NLR are independent risk factors for ACS，and their combination has better predictive value for ACS. Moreover，they are positively correlated with the severity of coronary lesions significantly，which may have potential to be biomarkers for ACS risk prediction and condition evaluation.