The Diagnostic Value of Hemogram Parameters for Myocardial Infarction in the Emergency Department

Abstract

Aim We aimed to evaluate the diagnostic value of hemogram-based inflammatory parameters particularly leukocyte, leukocyte-to-platelet ratio, and neutrophil-to-platelet ratio in identifying myocardial infarction among patients presenting to the emergency department with chest pain. Materials and Methods: A total of 60 myocardial infarction and 60 non- myocardial infarction patients aged over 18 years who presented to the emergency department with chest pain between January and February 2025 were retrospectively analyzed. Hemogram, biochemistry, electrocardiography, and creatine kinase-MB values were evaluated. leukocyte, , leukocyte-to-platelet and neutrophil-to-platelet ratios were compared between the two groups. The discriminatory performance of these parameters was assessed using Receiver Operating Characteristic analysis, and optimal cutoff values were determined using the Youden index. Results: Glucose, creatine kinase-MB, leukocyte, neutrophil count leukocyte-to-platelet ratio, and neutrophil-to-platelet ratio levels were significantly higher in the myocardial infarction group compared with the control group (p<0.001). In Receiver Operating Characteristic analysis, leukocyte-to-platelet ratio demonstrated the highest diagnostic accuracy with an AUC of 0.732. The cutoff value for leukocyte-to-platelet ratio was 0.0365, yielding a sensitivity of 71.7% and specificity of 66.7%. The AUC values for neutrophil-to-platelet ratio and glucose were 0.674 and 0.672, respectively. Conclusion: Rapid, low-cost, and readily accessible parameters such as leukocyte, leukocyte-to-platelet ratio and neutrophil-to-platelet ratio were shown to have significant discriminatory value in diagnosing myocardial infarction. Particularly, the high diagnostic accuracy of leukocyte-to-platelet ratio, supports its potential use as a practical biomarker to assist clinical decision-making while awaiting troponin results.

Keywords

• Myocardial infarction;
• leukocyte-to-platelet ratio;
• neutrophil-to-platelet ratio;
• leukocyte;
• emergency department

Acil Serviste Miyokard Enfarktüsünde Hemogram Parametrelerinin Tanısal Değeri

Abstract

Amaç: Bu çalışmada, acil servise göğüs ağrısı ile başvuran hastalarda miyokard enfarktüsünün tanısında lökosit sayısı, lökosit-trombosit oranı ve nötrofil-trombosit oranı gibi hemogram temelli inflamatuvar parametrelerin tanısal değerinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: Ocak–Şubat 2025 tarihleri arasında acil servise göğüs ağrısı ile başvuran, 18 yaş üzeri 60 miyokard enfarktüslü ve 60 miyokard enfarktüsü olmayan hasta retrospektif olarak incelendi. Hemogram, biyokimya, elektrokardiyografi ve kreatin kinaz-MB değerleri değerlendirildi. Lökosit sayısı, lökosit-trombosit oranı ve nötrofil-trombosit oranı iki grup arasında karşılaştırıldı. Tanısal performans alıcı işletim karakteristiği analizi ile değerlendirildi ve optimal eşik değerler Youden indeksi kullanılarak belirlendi. Bulgular: Glukoz, kreatin kinaz-MB, lökosit sayısı, nötrofil sayısı, lökosit-trombosit oranı ve nötrofil-trombosit oranı miyokard enfarktüsü grubunda kontrol grubuna göre anlamlı derecede daha yüksek bulundu (p<0.001). Alıcı işletim karakteristiği analizinde, lökosit-trombosit oranı en yüksek tanısal doğruluğa sahip olup eğri altında kalan alan değeri 0.732 olarak saptandı. Bu parametre için kesim değeri 0.0365 olup duyarlılık %71.7 ve özgüllük %66.7 idi. Sonuç: Hızlı, düşük maliyetli ve kolay erişilebilir hemogram parametreleri miyokard enfarktüsünün tanısında anlamlı katkı sağlayabilir. Özellikle lökosit-trombosit oranı, troponin sonuçları beklenirken klinik karar verme sürecini destekleyebilecek pratik bir biyobelirteç olabilir.

Keywords

• Miyokard enfarktüsü;
• lökosit-trombosit oranı;
• nötrofil-trombosit oranı;
• lökosit;
• acil servis

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