Assessment of neutrophil / lymphocyte ratio and monocyte count in patients with acute coronary syndrome in emergency department

Objective: Acute coronary syndromes are at the top of all death causes in the world and in our country. There are some tests routinely used in the diagnosis of acute coronary syndromes. There are also some risk scorings used in these patients at the same time. However, these risk scorers have very variable parameters. In this study, we aimed to investigate whether full blood count parameters are predictive of the clinical course of acute coronary syndromes. Matherial and Methods: The study included 330 patients with acute coronary syndrome who were admitted to the Emergency Department of Ankara Yildirim Beyazit University Ataturk Training and Research Hospital. Patient's demographics, total blood count parameters, neutrophil / lymphocyte ratio (NLR), TIMI and GRACE risk scores, and ECG findings were recorded. Length of stay, in-hospital mortality and 6-month mortality were followed. Results: In our study, 77.3% of the patients were male and 22.7% were female. The mean age was 61 ± 12. NLR values (p = 0.009) and monocyte counts (p <0.001) were significantly different in all groups in terms of in-hospital mortality. There was a significant difference in NLR values (p = 0,045) and monocyte counts (p = 0,026) in all groups in terms of 6-month mortality. There was no statistically significant difference between NLR 1 and other groups (p = 0,006) and between NLR 2 and 3 (p = 0,248) in terms of in-hospital mortality among NLR subgroups. There was no significant difference in the 6-month mortality between NLR subgroups in this study (p = 0.131). Correlation between GRACE score and troponin was moderate (p <0.001; rho = 0.482), between GRACE score and NLR was weak (p <0.001; rho = 0.393), and between troponin and NLR was weak (p <0.001; rho = 0.348). Conclusion: Some parameters such as number of neutrophils, number of neutrophils, number of monocytes, NLR, etc. obtained from whole blood counts which are cheap and fast results in patients following acute coronary syndrome in emergency services may help in predicting the prognosis and mortality of patients and clinical decision making process. Key Words: Acute coronary syndrome, neutrophil, lymphocyte, ratio, monocyte