Prognostic Factors in Patients with Acute Coronary Syndrome without ST Segment Elevation

Background: In patients with acute coronary syndromes (ACS) without ST segment elevation (SSE), it is suggested that a series of markers (inflammatory cells, hyperglycemia and renal function) can identify individuals with increased risk for cardiovascular events. Objective: To evaluate the impact of these laboratory parameters on intra-hospital outcomes of patients with ACS with no SSE. Methods: We prospectively evaluated 195 patients consecutively admitted with ACS with no SSE. Demographic and clinical laboratory data were recorded during the course of the hospitalization period in relation to the occurrence of combined events. Results: Mean age was 67 +/- 12 years, and 52% were men. In analyzing the area under the ROC curve, only neutrophil/lymphocyte ratios (AUC: 70%, CI 95% 56%-82%, p = 0.006) and creatinine (AUC: 62%, CI 95% 50%-80%, p = 0.03) discriminated those patients with ACS with no SSE who presented an adverse outcome. The patients who suffered an adverse event during hospitalization had lower lymphocyte counts (1502 +/- 731/mm(3) vs. 2020 +/- 862/mm(3); p = 0.002), lower glomerular filtration rates (51 +/- 27 mL/min vs. 77 +/- 34 mL/min; p < 0,001) and higher serum creatinine levels (2.1 +/- 2.7 mg/dL vs. 1.1 +/- 1.3 mg/dL; p = 0.047) than those who progressed through hospitalization without incident. The logistic regression analysis showed that variables remaining as independent and significant predictors were: glomerular filtration rate (OR: 1.03; CI 95%: 1.00 - 1.13, p = 0.002), and lymphocyte count (OR: 1.02; CI95%: 1.01 to 1.04, p = 0.03). Conclusion: Assessment of renal function and lymphocyte count provide potentially useful information for the prognostic stratification in patients with ACS with no SSE