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Kaplangoray M, Toprak K, Deveci E, Caglayan C, Şahin E. Could Pan-Immune-Inflammation Value be a Marker for the Diagnosis of Coronary Slow Flow Phenomenon? Cardiovasc Toxicol 2024; 24:519-526. [PMID: 38622332 PMCID: PMC11076385 DOI: 10.1007/s12012-024-09855-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/30/2024] [Indexed: 04/17/2024]
Abstract
Inflammation plays a key role in the pathogenesis of the coronary slow flow phenomenon (CSFP). The newly developed inflammatory marker, pan-immune-inflammation value (PIV), is associated with adverse cardiovascular events. This study investigated the predictive value of PIV for diagnosing CSFP in comparison to other inflammation-based markers. A total of 214 patients, 109 in the CSFP group and 105 in the normal coronary flow (NCF) group, were retrospectively included in the study. Coronary flow was calculated using the Thrombolysis in Myocardial Infarction frame count method. In addition to PIV, other inflammatory markers such as neutrophil-lymphocyte ratio, platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were calculated for the patients. The average age of patients was 50.3 ± 8.4, with a male ratio of 55.1%. Compared to the NCF group, patients in the CSFP group had higher levels of hyperlipidemia, glucose, triglyceride, NLR, PLR, SII, and PIV, while their high-density lipoprotein cholesterol (HDL-C), was lower (p < 0.05). Logistic regression analysis demonstrated that HDL-C, glucose, triglyceride, and PIV were independent predictor factors for CSFP (p < 0.05). PIV is a strong and independent predictor factor for CSFP and superior in predicting CSFP compared to other inflammatory markers.
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Affiliation(s)
- Mustafa Kaplangoray
- Department of Cardiology, Faculty of Medicine, Bilecik Şehy Edebali University, Bilecik, Turkey.
| | - Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Şanlıurfa, Turkey
| | - Edhem Deveci
- Department of Cardiology, University of Health Sciences, Mehmet Akif İnan Research and Training Hospital, Şanlıurfa, Turkey
| | - Cuneyt Caglayan
- Department of Medical Biochemistry, Faculty of Medicine, Bilecik Şehy Edebali University, Bilecik, Turkey.
| | - Ebru Şahin
- Department of Cardiology, Bilecik Training and Research Hospital, Bilecik, Turkey
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Pinto JM, Nogueira LS, Rios DRA. Hematological parameters: is there a difference between those released by the hematological analyzer and to the customer? EINSTEIN-SAO PAULO 2023; 21:eAO0501. [PMID: 38126661 PMCID: PMC10730264 DOI: 10.31744/einstein_journal/2023ao0501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/08/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE This study aimed to compare the hematological parameters released by hematological analyzers with those released in customer reports. METHODS We conducted a descriptive study in the laboratories of a medium-sized municipality in the state of Minas Gerais registered in the National Register of Health Establishments. Interviews were conducted using a questionnaire to obtain information regarding the parameters released by the analyzers and those available in the customer's report. RESULTS Sixteen laboratories were evaluated, and none of them released all the parameters obtained from the hematological analyzers to customers. The red blood cell distribution width was released in 88% of the laboratories, atypical lymphocytes in 70%, mean platelet volume in 50%, platelet distribution width and platelet count in 20%. No laboratory released information on reticulocytes, fraction of immature reticulocytes and immature granulocytes, nucleated erythrocyte count, immature platelet fraction and reticulocyte hemoglobin, and large platelet rate. CONCLUSION All evaluated clinical analysis laboratories had at least one parameter that was not released in the customer's report despite being released by the hematological analyzers. The lack of knowledge on the part of professionals about the clinical importance of each parameter of the complete blood count results in a loss in patient assessment, and it is important to include these parameters in the complete blood count report.
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Affiliation(s)
- Jhenifer Monique Pinto
- Campus Centro Oeste Dona LinduUniversidade Federal de São João del-ReiDivinópolisMGBrazil Campus Centro Oeste Dona Lindu
,
Universidade Federal de São João del-Rei
,
Divinópolis
,
MG
,
Brazil
.
| | - Leilismara Sousa Nogueira
- Department of Clinical and Toxicological AnalysisUniversidade Federal de AlfenasAlfenasMGBrazil Department of Clinical and Toxicological Analysis
,
Universidade Federal de Alfenas
,
Alfenas
,
MG
,
Brazil
.
| | - Danyelle Romana Alves Rios
- Campus Centro Oeste Dona LinduUniversidade Federal de São João del-ReiDivinópolisMGBrazil Campus Centro Oeste Dona Lindu
,
Universidade Federal de São João del-Rei
,
Divinópolis
,
MG
,
Brazil
.
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Xia W, Jiang T, Tan Y, Li C, Wu S, Mei B. Characteristics of hematological parameters on admission in COVID-19 Omicron variant infected in Chinese population: a large-scale retrospective study. BMC Infect Dis 2023; 23:835. [PMID: 38012548 PMCID: PMC10683119 DOI: 10.1186/s12879-023-08771-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The Omicron variant of SARS-CoV-2, currently the most prevalent strain, has rapidly spread in Jingzhou, China, due to changes in the country's epidemic prevention policy, resulting in an unprecedented increase in cases. Previous studies reported hematological parameters' predictive value in COVID-19 severity and prognosis, but their relevance for early diagnosis in patients infected by the Omicron variant, particularly in high-risk pneumonia cases, remains unclear. Our study aimed to evaluate these parameters as early warning indicators for Omicron-infected patients in fever clinics and those with pulmonary infections (PI). METHODS A total of 2,021 COVID-19 patients admitted to the fever clinic and infectious disease department of Jingzhou Hospital Affiliated to Yangtze University from November 1, 2022, to December 31, 2022, were retrospectively recruited. Demographic and hematological parameters were obtained from the electronic medical records of eligible patients. These hematological parameters were analyzed by receiver operating characteristic (ROC) curves to determine whether they can be used for early diagnosis of COVID-19 patients in fever clinics and the presence of PI in COVID-19 patients. RESULTS Statistical differences in hematological parameters were observed between COVID-19 patients with fever and PI and control groups (P < 0.01). The ROC curve further demonstrated that lymphocyte (LYM) counts, neutrophil (NEU) counts, monocyte-to-lymphocyte ratios (MLR), platelet-to-lymphocyte ratios (PLR), white blood cell counts (WBC), and mean corpuscular hemoglobin concentration (MCHC) were the top 6 indicators in diagnosing Omicron infection with fever, with area under the curve (AUC) values of 0.738, 0.718, 0.713, 0.702, 0.700, and 0.687, respectively (P < 0.01). Furthermore, the mean platelet volume (MPV) with an AUC of 0.764, red blood cell count (RBC) with 0.753, hematocrit (HCT) with 0.698, MLR with 0.694, mean corpuscular hemoglobin (MCH) with 0.676, and systemic inflammation response indexes (SIRI) with 0.673 were the top 6 indicators for the diagnosis of COVID-19 patients with PI (P < 0.01). CONCLUSIONS LYM, NEU, MLR, PLR, WBC, and MCHC can serve as potential prescreening indicators for Omicron infection in fever clinics. Additionally, MPV, RBC, HCT, MLR, MCH, and SIRI can predict the presence of PI in COVID-19 patients infected by the Omicron variant.
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Affiliation(s)
- Wei Xia
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, China
| | - Tao Jiang
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, China
| | - Yafeng Tan
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, China
| | - Chengbin Li
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, China
| | - Song Wu
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, China
| | - Bing Mei
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, China.
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Poudineh M, Mansoori A, Sadooghi Rad E, Hosseini ZS, Salmani Izadi F, Hoseinpour M, Mahmoudi Zo M, Ghoflchi S, Tanbakuchi D, Nazar E, Ferns G, Effati S, Esmaily H, Ghayour-Mobarhan M. Platelet distribution widths and white blood cell are associated with cardiovascular diseases: data mining approaches. Acta Cardiol 2023; 78:1033-1044. [PMID: 37694924 DOI: 10.1080/00015385.2023.2246199] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 06/12/2023] [Accepted: 08/03/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE To investigate the association between cardiovascular diseases (CVDs) and haematologic factors in a cohort of Iranian adults. METHOD For a total population of 9,704 aged 35 to 65, a prospective study was designed. Haematologic factors and demographic characteristics (such as gender, age, and smoking status) were completed for all participants. The association between haematologic factors and CVDs was assessed through logistic regression (LR) analysis, decision tree (DT), and bootstrap forest (BF). RESULTS Almost all of the included factors were significantly associated with CVD (p<.001). Among the included factors, were: age, white blood cell (WBC), and platelet distribution width (PDW) had the strongest correlation with the development of CVD. For unit OR interpretation, WBC has been represented as the most remarkable risk factor for CVD (OR: 1.22 (CI 95% (1.18, 1.27))). Also, age is associated with an increase in the odds of CVD + occurrence (OR: 1.12 (CI 95% (1.11, 1.13))). Moreover, males are times more likely to develop CVD than females (OR: 1.39 (CI 95% (1.22, 1.58))). In DT model, age is the best classifier factor in CVD development, followed by WBC and PDW. Furthermore, based on the BF algorithm, the most crucial factors correlated with CVD are age, WBC, PDW, sex, and smoking status. CONCLUSION The obtained result from LR, DT, and BF models confirmed that age, WBC, and PDW are the most crucial factors for the development of CVD.
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Affiliation(s)
- Mohadeseh Poudineh
- Student Research Committee, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Amin Mansoori
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elias Sadooghi Rad
- Student Research Committee, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Faezeh Salmani Izadi
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdieh Hoseinpour
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mostafa Mahmoudi Zo
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sahar Ghoflchi
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Davoud Tanbakuchi
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Eisa Nazar
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Applied Mathematics, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Gordon Ferns
- Brighton and Sussex Medical School, Division of Medical Education, Brighton, United Kingdom
| | - Sohrab Effati
- Department of Applied Mathematics, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
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Almetairi KN, Alasmari SZ, Makkawi MH, Shaikh AA. Prevalence, hematological parameters, and coagulation profiles: Cardiovascular diseases statistics in the Asir region, Saudi Arabia. Saudi Med J 2023; 44:385-393. [PMID: 37062554 PMCID: PMC10153605 DOI: 10.15537/smj.2023.44.4.20220746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 02/16/2023] [Indexed: 04/18/2023] Open
Abstract
OBJECTIVES To determine the prevalence of cardiovascular disease (CVD) types in the Asir region of Saudi Arabia and the importance of hematological testing for CVD patients in the context of disease management. METHODS This retrospective study comprised 416 CVD patients, and samples were divided based the type of CVD. The Mann Whitney U test was used to compare patients' hematological markers and coagulation profiles to those of healthy controls. RESULTS The rate of ischemic heart disease (IHD) was 80.7% that of other CVDs, and the rate of ST-elevation myocardial infarction (STEMI) was 37.3% the rate of CVD. Significant differences were observed in the hematological and coagulation parameters of CVD patients compared to the control group. White blood cells (WBC) were significantly higher in STEMI, non-ST-elevation myocardial infarction (NSTEMI), unstable angina (UA), and heart failure (HF) groups. Red blood cells (RBC) were significantly lower in STEMI, NSTEMI, UA, chronic coronary syndrome (CCS), HF, dilated cardiomyopathy (DCM), and ischemic cardiomyopathy (ICM). Red distribution width (RDW) was significantly greater in the HF, DCM, and ICM groups. Prothrombin time (PT) was significantly higher in the STEMI, HF, and DCM groups. CONCLUSION ST-elevation myocardial infarction has a higher prevalence rate among CVD patients in the Asir region. Both coagulation and hematological indicators have high potential utility as CVD diagnostic and prognostic markers.
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Affiliation(s)
- Kholoud N. Almetairi
- From the Department of Clinical Laboratory Sciences (Kholoud, Sultan, Mohammed, Ahmed), Faculty of Applied Medical Sciences, King Khalid University, Abha; from Department of Laboratory (Kholoud), Prince Faisal bin Khalid Cardiac Center, Abha, Kingdom of Saudi Arabia.
| | - Sultan Z. Alasmari
- From the Department of Clinical Laboratory Sciences (Kholoud, Sultan, Mohammed, Ahmed), Faculty of Applied Medical Sciences, King Khalid University, Abha; from Department of Laboratory (Kholoud), Prince Faisal bin Khalid Cardiac Center, Abha, Kingdom of Saudi Arabia.
| | - Mohammed H. Makkawi
- From the Department of Clinical Laboratory Sciences (Kholoud, Sultan, Mohammed, Ahmed), Faculty of Applied Medical Sciences, King Khalid University, Abha; from Department of Laboratory (Kholoud), Prince Faisal bin Khalid Cardiac Center, Abha, Kingdom of Saudi Arabia.
| | - Ahmad A. Shaikh
- From the Department of Clinical Laboratory Sciences (Kholoud, Sultan, Mohammed, Ahmed), Faculty of Applied Medical Sciences, King Khalid University, Abha; from Department of Laboratory (Kholoud), Prince Faisal bin Khalid Cardiac Center, Abha, Kingdom of Saudi Arabia.
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KOCATÜRK İ, GÜLTEN S. Immature granulocyte and other markers in prediction of mortality in spontaneous intracerebral hemorrhage. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2023. [DOI: 10.32322/jhsm.1225428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Aim: This study aims to evaluate immature granulocyte count (IG#) and percentage (IG%) in the prediction of mortality in spontaneous intracerebral hemorrhage (SICH).
Material and Method: Demographic characteristics and laboratory test results of patients diagnosed with SICH and admitted to the neurology clinic in a tertiary hospital between January 1, 2020, and January 1, 2022, were recorded. One hundred ten patients were included in the study. While 80 of these patients constituted the group that recovered after treatment, 30 of them formed the group that died despite treatment. IG and other laboratory and clinic parameters were statistically compared in both groups.
Results: Of 110 patients, 45 (42.7%) were female, and 65 (57.3%) were male. IG counts were higher in the non-survival group than in the survival group (p=0.001). When the patients were divided according to low IG% (=0.6), 30 patients were in the high IG# group, and 80 patients were in the low IG% group. White blood cell (WBC), neutrophil count (NEUT#), monocyte count (MONO#), IG#, neutrophil-lymphocyte ratio (NLR), and hemorrhage volume (HV) values were statistically significantly higher in the high IG% group than in the low IG% group; Glasgow coma score (GCS) and percentage of lymphocytes (LYMPH%) values were significantly lower too. In addition, the mortality rate in the high IG# group was significantly higher than the mortality rate in the low IG% group (53.23% vs. 17.5%).
Conclusion: IG is a new, easily accessible, inexpensive, and promising marker for predicting in-hospital mortality in patients with SICH.
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The relationship between fragmented QRS and mortality in without reversible defects patients with scintigraphical myocardial infarction diagnosis. JOURNAL OF SURGERY AND MEDICINE 2022. [DOI: 10.28982/josam.1013404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background/Aim: Evidence of increased mortality in perfusion abnormalities on myocardial perfusion scintigraphy (MPS) can be found. However, electrocardiography (ECG) is a cheaper and more easily accessible examination than MPS. Fragmented QRS (fQRS) is also considered to be associated with mortality in some cardiological diseases. The present study aimed to analyze the relationship between fQRS based on electrocardiography (ECG) and mortality in patients without reversible defects whose fixed hypoperfusion/perfusion defects were diagnosed and associated with myocardial infarction (MI) based on myocardial perfusion scintigraphy (MPS).
Methods: Non-ischemic patients (2289 patients) with MI diagnoses based on scintigraphy were selected based on retrospective scintigraphy reports. The presence of fQRS was investigated in 85 patients whose 12-lead electrocardiographs could be accessed from the hospital archive, and their deaths due to all causes were questioned from the death information system. The relationship between left ventricular ejection fraction (LVEF), fQRS, type of exercise, number of leukocytes, other parameters, and mortality rates was analyzed.
Results: The numbers of living (n = 69) and deceased (n = 16) patients were obtained. They were divided into two groups: (1) surviving patients (n = 69, number of fQRS positive 42) and (2) deceased (n = 16, number of fQRS positive 11). No distributional differences were found between mortality rates and fQRS and demographic features between groups (P = 0.558). However, a statistically significant effect was observed between mortality rates and low LVEF levels, pharmacological stress, number of leukocytes, and a low HDL level.
Conclusion: The present study suggests that it may be useful to define benign features of fQRS. LVEF levels may be a very important parameter in decision-making for pharmacological stress, and its role in prediction of mortality may be higher than that obtained by fQRS.
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Zhang Y, Wang Q, Mackay CR, Ng LG, Kwok I. Neutrophil subsets and their differential roles in viral respiratory diseases. J Leukoc Biol 2022; 111:1159-1173. [PMID: 35040189 PMCID: PMC9015493 DOI: 10.1002/jlb.1mr1221-345r] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 12/28/2021] [Accepted: 01/04/2022] [Indexed: 12/19/2022] Open
Abstract
Neutrophils play significant roles in immune homeostasis and as neutralizers of microbial infections. Recent evidence further suggests heterogeneity of neutrophil developmental and activation states that exert specialized effector functions during inflammatory disease conditions. Neutrophils can play multiple roles during viral infections, secreting inflammatory mediators and cytokines that contribute significantly to host defense and pathogenicity. However, their roles in viral immunity are not well understood. In this review, we present an overview of neutrophil heterogeneity and its impact on the course and severity of viral respiratory infectious diseases. We focus on the evidence demonstrating the crucial roles neutrophils play in the immune response toward respiratory infections, using influenza as a model. We further extend the understanding of neutrophil function with the studies pertaining to COVID‐19 disease and its neutrophil‐associated pathologies. Finally, we discuss the relevance of these results for future therapeutic options through targeting and regulating neutrophil‐specific responses.
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Affiliation(s)
- Yuning Zhang
- Department of Research, National Skin Centre, Singapore, Singapore
| | - Quanbo Wang
- School of Pharmaceutical Sciences, Shandong Analysis and Test Center, Qilu University of Technology (Shandong Academy of Sciences), Jinan, China
| | - Charles R Mackay
- School of Pharmaceutical Sciences, Shandong Analysis and Test Center, Qilu University of Technology (Shandong Academy of Sciences), Jinan, China.,Department of Microbiology, Infection and Immunity Program, Biomedicine Discovery Institute, Monash University, Melbourne, Australia
| | - Lai Guan Ng
- Singapore Immunology Network (SIgN), A*STAR (Agency for Science, Technology and Research), Biopolis, Singapore.,State Key Laboratory of Experimental Hematology, Institute of Hematology, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.,School of Biological Sciences, Nanyang Technological University, Singapore, Singapore.,Department of Microbiology and Immunology, Immunology Translational Research Program, Yong Loo Lin School of Medicine, Immunology Program, Life Sciences Institute, National University of Singapore, Singapore, Singapore.,National Cancer Centre Singapore, Singapore, Singapore
| | - Immanuel Kwok
- Singapore Immunology Network (SIgN), A*STAR (Agency for Science, Technology and Research), Biopolis, Singapore
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Biomarkers of Inflammation and Inflammation-Related Indexes upon Emergency Department Admission Are Predictive for the Risk of Intensive Care Unit Hospitalization and Mortality in Acute Poisoning: A 6-Year Prospective Observational Study. DISEASE MARKERS 2021; 2021:4696156. [PMID: 34457088 PMCID: PMC8390135 DOI: 10.1155/2021/4696156] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/04/2021] [Indexed: 11/28/2022]
Abstract
Patients poisoned with drugs and nonpharmaceutical substances are frequently admitted from the emergency department (ED) to a medical or ICU department. We hypothesized that biomarkers of inflammation and inflammation-related indexes based on the complete blood cell (CBC) count can identify acutely poisoned patients at increased risk for ICU hospitalization and death. We performed a 6-year prospective cohort study on 1548 adult patients. The demographic data, the levels of hs-CRP (high-sensitivity C-reactive protein), CBC, and inflammation-related indexes based on CBC counts were collected upon admission and compared between survivors and nonsurvivors, based on the poison involved. Both a multivariate logistic regression model with only significant univariate predictors and a model including univariate predictors plus each log-transformed inflammation-related indexes for mortality were constructed. The importance of the variables for mortality was graphically represented using the nomogram. hs-CRP (odds ratio (OR), 1.38; 95% CI, 1.16–1.65, p < 0.001 for log-transformed hs-CRP), red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were significantly associated with the risk of ICU hospitalization, after multivariable adjustment. Only RDW, NLR, and monocyte-lymphocyte ratio (MLR) were significantly associated with mortality. The predictive accuracy for mortality of the models which included either NLR (AUC 0.917, 95% CI 0.886-0.948) or MLR (AUC 0.916, 95% CI 0.884-0.948) showed a high ability for prognostic detection. The use of hs-CRP, RDW, NLR, and MLR upon ED admission are promising screening tools for predicting the outcomes of patients acutely intoxicated with undifferentiated poisons.
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10
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Dong G, Huang A, Liu L. Platelet-to-lymphocyte ratio and prognosis in STEMI: A meta-analysis. Eur J Clin Invest 2021; 51:e13386. [PMID: 32810283 DOI: 10.1111/eci.13386] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 07/27/2020] [Accepted: 08/15/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Platelet-to-lymphocyte ratio (PLR) is a haematological index which reflects increased level of inflammation and thrombosis. We aimed to summarize the potential prognostic role of PLR for the in-hospital and long-term outcomes in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (pPCI) in a meta-analysis. MATERIALS AND METHODS Relevant cohort studies were identified by search the PubMed, Cochrane's Library and Embase databases. A random-effect model was applied to pool the results. In-hospital and long-term outcomes were compared between patients with higher and lower preprocedural PLR. RESULTS Eleven cohorts with 12 619 patients were included. Pooled results showed that higher preprocedural PLR was independently associated with increased risk of in-hospital major adverse cardiovascular events (MACE, risk ratio [RR]: 1.76, 95% confidence interval [CI]: 1.39 to 2.22, P < .001; I2 = 49%), cardiac mortality (RR: 1.91, 95% CI: 1.18 to 3.09, P = .009; I2 = 0), all-cause mortality (RR: 2.14, 95% CI: 1.52 to 3.01, P < .001, I2 = 24%) and no reflow after pPCI (RR: 2.22, 95% CI: 1.70 to 2.90, P < .001, I2 = 59%). Moreover, higher preprocedural PLR was associated with increased risk of MACE (RR: 1.60, 95% CI: 1.25 to 2.03, I2 = 57%, P < .001) and all-cause mortality (RR: 2.36, 95% CI: 1.53 to 3.66, I2 = 78%, P < .001) during long-term follow-up of up to 82 months after discharge. CONCLUSIONS Higher PLR predicts poor in-hospital and long-term prognosis in STEMI patients after pPCI.
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Affiliation(s)
- Guoxia Dong
- Department of General Practice, Affiliated Hospital of Jining Medical University, Jining, China
| | - Aiqin Huang
- Cardiac Care Unit, Affiliated Hospital of Jining Medical University, Jining, China
| | - Lei Liu
- Department of General Practice, Affiliated Hospital of Jining Medical University, Jining, China
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11
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Narcı H, Berkeşoğlu M, Üçbilek E, Ayrık C. The usefulness of the percentage of immature granulocytes in predicting in-hospital mortality in patients with upper gastrointestinal bleeding. Am J Emerg Med 2020; 46:646-650. [PMID: 33358899 DOI: 10.1016/j.ajem.2020.12.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/13/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Upper gastrointestinal bleeding (UGIB) is an important health problem with a potentially life threatening course. Measurement of immature granulocytes percentage (IG %), reflecting the fraction of circulating immature granulocyte (IG), is associated with increased mortality in patients with systemic inflammation, or distress. The aim of this study was to evaluate whether the IG% is an effective predictive marker for estimating the in-hospital mortality for patients with UGIB admitting to the emergency department (ED). METHOD This retrospective study included patients with UGIB who admitted to the ED, between 01.01.2019 and 31.12.2019. The patients were divided into two groups as discharged and dead. The IG% and other parameters were recorded. The primary end point of the study was in-hospital mortality. Logistic regression model was used to determine the factors affecting mortality. RESULTS This study included 149 patients, 94 of whom were men. The mean age of the patients was 64.5 ± 14.2. Twenty patients died during hospitalization and 129 were discharged. IG% was significantly higher in patients who died compared with patients who discharged. In the receiver operating characteristic (ROC) curves analysis to determine the in-hospital mortality, the cut-off value (>1%) for IG% level was found specificity (93.8%), sensitivity (100%), positive predictive value (PPV = 71.43%), negative predictive value (NPV = 100.00%) and area under curve (AUC = 0.98). Univariate logistic regression analysis showed that IG% was predicting in-hospital mortality (odds ratio, OR = 65.6, confidence interval, CI = 2.00-2152.6). CONCLUSıONS: High IG% levels may be used as a predictor of in-hospital mortality in patients with UGIB.
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Affiliation(s)
- Hüseyin Narcı
- Mersin University, Faculty of Medicine, Department of Emergency Medicine, Mersin, Turkey.
| | - Mustafa Berkeşoğlu
- Mersin University, Faculty of Medicine, Department of General Surgery, Mersin, Turkey
| | - Enver Üçbilek
- Associate professor, Mersin University, Faculty of Medicine, Department of Gastroenterology, Mersin, Turkey
| | - Cüneyt Ayrık
- Mersin University, Faculty of Medicine, Department of Emergency Medicine, Mersin, Turkey
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Sigirci S, Ser ÖS, Keskin K, Yildiz SS, Gurdal A, Kilickesmez KO. Comparing the Prognostic Value of Hematological Indices in Patients With ST Segment Elevation Myocardial Infarction: "A Head to Head" Analysis. Angiology 2020; 72:348-354. [PMID: 33272027 DOI: 10.1177/0003319720977754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although there are reviews and meta-analyses focusing on hematological indices for risk prediction of mortality in patients with ST segment elevation myocardial infarction (STEMI), there are not enough data with respect to direct to head-to-head comparison of their predictive values. We aimed to investigate which hematological indices have the most discriminatory capability for prediction of in-hospital and long-term mortality in a large STEMI cohort. We analyzed the data of 1186 patients with STEMI. In-hospital and long-term all-cause mortality was defined as the primary end point of the study. In-hospital mortality rate was 8.6% and long-term mortality rate 9.0%. Although the neutrophil to lymphocyte ratio (NLR) and age were found to be independent predictors of in-hospital mortality in the multivariate regression analyses; Cox regression analysis revealed that age, ejection fraction, red cell distribution width (RDW), and monocyte to high-density lipoprotein ratio (MHDLr) were independently associated with long-term mortality. Neutrophil to lymphocyte ratio had the highest area under curve value in the receiver operating characteristic curve analyses for prediction of in-hospital mortality. In conclusion, while NLR may be used for prediction of in-hospital mortality, RDW and MHDLr ratio are better hematological indices for long-term mortality prediction after STEMI than other most common indices.
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Affiliation(s)
- Serhat Sigirci
- Department of Cardiology, 64159Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Özgür Selim Ser
- Department of Cardiology, 64159Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Kudret Keskin
- Department of Cardiology, 64159Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Süleyman Sezai Yildiz
- Department of Cardiology, 64159Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Ahmet Gurdal
- Department of Cardiology, 64159Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - Kadriye Orta Kilickesmez
- Department of Cardiology, 64159Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
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Monteiro JGDM, Sobral DC. Potential Role of Hematological Parameters in Patients with Acute Myocardial Infarction: viewpoint. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2020. [DOI: 10.36660/ijcs.20200108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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14
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Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio in Branch Retinal Vein Occlusion. J Ophthalmol 2019; 2019:6043612. [PMID: 31885890 PMCID: PMC6925675 DOI: 10.1155/2019/6043612] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 09/27/2019] [Indexed: 12/18/2022] Open
Abstract
Purpose. To evaluate the neutrophil/lymphocyte ratio (NLR) and the platelet/lymphocyte ratio(PLR) value in the development of branch retinal vein occlusion (BRVO)patients. Methods. 81 patients with BRVO and 81 age and sex-matched subjects were recruited as the control group. The BRVO diagnosis was confirmed under comprehensive ophthalmologic examinations. NLR and PLR parameters obtained from peripheral blood were recorded. Results. Both the mean NLR and PLR was significantly higher in the BRVO group compared with the control group (p < 0.001). In ROC analysis, the AUC for NLR was 0.82, and NLR of >2.48 predicted BRVO with a sensitivity of 58% and specificity of 98%. The AUC for PLR was 0.78, and PLR of >110.2 predicted BRVO with a sensitivity of 72% and specificity of 72%. Conclusion. The current study demonstrated that BRVO patients had increased NLR and PLR levels compared with control subjects. The NLR and PLR may be used as independent predictors for identifying risk for the development of BRVO.
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Sobral Filho DC, Monteiro Júnior JGDM. High Residual Platelet Activity in Response to Acetylsalicylic Acid in Acute Coronary Syndrome: A New Challenge for Antiplatelet Treatment? Arq Bras Cardiol 2019; 113:364-366. [PMID: 31621775 PMCID: PMC6882403 DOI: 10.5935/abc.20190199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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