Haematological indices in acute coronary syndromes: Could there be a hidden message?

Introduction and Aim: The routine markers of CAD show elevation after the development of acute manifestations. There exists a need for the establishment/validation of biomarkers that predict preclinical atherosclerotic changes. This study assesses the utility of haematological indices in the prediction and prognostication of CAD. Materials and Methods: This retrospective study includes 830 patient reports investigated for serum Troponin T retrieved from the laboratory information system. Reports were grouped into positive and negative categories. Relevant haematological and biochemical data were retrieved. Statistical analysis was carried out to estimate group differences, correlation, sensitivity, specificity, and AUC. Results: Troponin T positive group showed significantly elevated WBCs, neutrophils, CRP, NLR, PLR, and SII with significantly low lymphocytes, monocytes, basophils and RBC count. None of the lipid profile parameters, except serum triglyceride, showed significant differences between groups. Males showed a higher baseline but a blunter elevation CRP during acute coronary events. ROC showed maximum sensitivity (75.9%) and NPV (77.9%) for NLR, while PLR showed maximum specificity (76.4%). Conclusion: Haematological indices may have a better predictive value than conventional lipid profile and might serve as key markers in novel cardiac risk screening panels and aid in the risk stratification and management of coronary artery diseases.