Calculated Hematological Indices as Predictors of Cardiovascular Complications in Noncardiac Surgery (Pilot Study)

Aim. To evaluate the predictive potential of the parameters of complete blood count (CBC), lipid profile and their ratios for predicting obstructive coronary artery disease (oCAD) in patients with non-ST elevation acute coronary syndrome (NSTEACS).Material and methods. The study included 600 patients with NSTE-ACS with a median age of 62 years who underwent invasive coronary angiography (CA). Two groups were formed, the first of which consisted of 360 (60%) patients with oCAD (stenosis ≥50%), and the second — 240 (40%) with coronary stenosis <50%. The clinical and functional status of patients before CAG was assessed by 33 parameters, including parameters of CBC, lipid profile and their ratio. For statistical processing and data analysis, the Mann-Whitney, Fisher, chi-squared tests, univariate logistic regression (LR) were used, while for the creation of predictive models, multivariate LR (MLR) was used. The quality was assessed by 4 metrics: area under the ROC curve (AUC), sensitivity (Se), specificity (Sp), and accuracy (Ac).Results. CBC and lipid profile analysis made it possible to identify factors that are linearly and non-linearly associated with oCAD. Univariate LR revealed their threshold values with the highest predictive potential. The quality metrics of the best prognostic model developed using MLR were as follows: AUC — 0,80, Sp — 0,79, Ac — 0,76, Se — 0,78. Its predictors were 8 following categorical parameters: age >55 years in men and >65 years in women, lymphocyte count (LYM) <19%, hematocrit >49%, immune-inflammation index >1000, high density lipoprotein cholesterol (HDL-C) to low density lipoprotein cholesterol (LDL-C) ratio <0,3, monocyte (MON)-to-HDL-C ratio >0,8, neutrophil (NEUT)-to-HDL-C ratio >5,7 and NEUT/LYM >3. The relative contribution of individual predictors to the development of end point was determined.Conclusion. The predictive algorithm (model 9), developed on the basis of MLR, showed a better quality metrics ratio than other models. The following 3 factors had the dominant influence on the oCAD risk: HDL-C/LDL-C (38%), age of patients (31%), and MON/HDL-C (14%). The influence of other factors on the oCAD risk was less noticeable.

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Parameters of complete blood count, lipid profile and their ratios in predicting obstructive coronary artery disease in patients with non-ST elevation acute coronary syndrome

Tsivanyuk

Гельцер

Shakhgeldyan

et al. 2022

Russ J Cardiol

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Accuracy of predictors of perioperative cardiovascular complications in onco-surgery

Соколов¹,

Жбанников²,

Ganert³

et al. 2023

Anaes. i reanim.

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Myocardial injury in patients with hypertonic disease at osteosynthesis of the hip and spinal anesthesia

Komarov

Соколов

Ganert

et al. 2022

Regional Anesthesia and Acute Pain Management

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BACKGROUND: Perioperative myocardial injury (MI) and MI after noncardiac surgery (MINS) makes a significant contribution to the structure of complications and mortality in non-cardiac surgery, including those in traumatology. Spinal anesthesia (SA) is usually used for hip surgery. It may be accompanied by arterial hypotension, which, under certain conditions, becomes a leading factor in MI development. Features of both hypotension and MI in patients with concomitant cardiovascular pathology operated on for hip injury remain insufficiently studied. AIM: To determine the frequency of intraoperative arterial hypotension and MI after intraosseous osteosynthesis of the hip under spinal anesthesia in patients with concomitant cardiovascular pathology. MATERIAL AND METHODS: In 275 patients with concomitant cardiovascular pathology, intraosseous synthesis of the hip was performed with SA. The functional class of the patients was assessed according to the American Society of Anesthesiologists scale and the risk of cardiac complications according to the Revised Cardiac Risk Index scale. Blood pressure, heart rate, electrocardiogram, and ST segment were monitored. Before surgery and 13 days thereafter, the troponin T level was measured. The frequency of MI and surgical outcomes were assessed. RESULTS: In the studied sample of patients with hypertonic disease, arterial hypotension associated with SA was observed in 34.2% of cases. Its frequency increased from 15.7% in patients without other comorbidities to 42.9% in patients with a combination of hypertonic disease, CAD, and CHF. A significant relationship was noted between arterial hypotension and MI. A highly sensitive troponin test revealed a significant incidence of myocardial damage (18.2%), and the associated 3-day mortality was 4%. CONCLUSION: SA-induced arterial hypotension is associated with MI risk and appears to be the most dangerous in patients with a combination of hypertonic disease, CAD, and CHF. Monitoring of troponin T levels in patients with risk factors of MI is one of the ways to reduce postoperative mortality and improve surgery outcomes.

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Calculated Hematological Indices as Predictors of Cardiovascular Complications in Noncardiac Surgery (Pilot Study)

Cited by 5 publications

References 34 publications

Parameters of complete blood count, lipid profile and their ratios in predicting obstructive coronary artery disease in patients with non-ST elevation acute coronary syndrome

Parameters of complete blood count, lipid profile and their ratios in predicting obstructive coronary artery disease in patients with non-ST elevation acute coronary syndrome

Accuracy of predictors of perioperative cardiovascular complications in onco-surgery

Myocardial injury in patients with hypertonic disease at osteosynthesis of the hip and spinal anesthesia

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