The relationship of hematologic and cardiac parameters with gensini score and mortality in patients with acute coronary syndrome applying to the emergency department

THE RELATIONSHIP OF HEMATOLOGIC AND CARDIAC PARAMETERS WITH GENSINI SCORE AND MORTALITY IN PATIENTS WITH ACUTE CORONARY SYNDROME APPLYING TO THE EMERGENCY DEPARTMENT Coronary artery disease (CAD) is one of the leading causes of cardiovascular mortality and morbidity worldwide. Acute coronary syndromes (ACS) are sudden and severe clinical manifestations of CAD that require emergency intervention. The pathophysiology of ACS develops through the interaction of complex and inflammatory processes such as atherosclerotic plaque rupture, platelet activation, and coagulation cascade. Studies on the prognostic value of hematological and cardiac parameters in ACS patients indicate that these parameters may provide important insights into the pathophysiology and prognosis of ACS. The aim of this study is to investigate the relationship between hematological and cardiac parameters, the Gensini score, which indicates the severity of coronary artery stenosis, and mortality in ACS patients admitted to the emergency department. A better understanding of this relationship can guide clinical practice and improve patients' quality of life. This thesis study was conducted in the emergency department of Suleyman Demirel University (SDU) Hospital with the approval of the Clinical Research Ethics Committee of SDU Faculty of Medicine. In this retrospective study, demographic data, cardiac and inflammatory markers found in routine laboratory parameters, Gensini scores, ACS types, and mortality statuses of patients diagnosed with ACS were recorded. Gensini scores were calculated according to coronary angiography reports, and patients were divided into low, medium, and high-risk groups based on these scores. The relationships between the parameters, Gensini score, and mortality in different ACS subtypes were statistically evaluated. The findings of 203 patients with an average age of 63.69, 141 (69.5%) of whom were male, were analyzed in terms of patients' parameters, Gensini scores, and outcomes (surviving or deceased). The average Gensini score was 51.14, while this number was 31.92 in USAP patients, 51.73 in non-STEMI patients, and 63.47 in STEMI patients. When the parameters of the patients included in the study were evaluated according to mortality, a statistically significant relationship was found between age, eGFR, creatinine, neutrophil, lymphocyte, RDW, Troponin I, Troponin I/creatinine ratio, neutrophil/lymphocyte ratio, PLT/lymphocyte ratio, Gensini score, and mortality. When patients were evaluated according to Gensini scores, a statistically significant relationship was found between age, eGFR, and Troponin I values and the Gensini score. The use of these parameters can improve patient outcomes and reduce mortality by providing a rapid and effective risk assessment in emergency departments. In future studies, examining the relationship of these parameters with other clinical markers and long-term outcomes will contribute to the development of new approaches in the management of acute coronary syndrome. In conclusion, this study showed that hematological and cardiac parameters evaluated in the emergency department of patients with acute coronary syndrome have significant relationships with the Gensini score and mortality. Especially age, eGFR, creatinine, neutrophil, Troponin I, Troponin I/creatinine ratio, MPV, RDW, NLR, and PLR levels have significant effects on the Gensini score and short-term mortality risk. High levels of these parameters may indicate poor prognosis and the necessity for urgent medical intervention. Key words: ACS, NLR, PLR, Gensini score, Mortality