title: Prognostic factors in patients with acute coronary syndrome without ST segment elevation.
abstract: 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/mm³; 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).
  
  
  CONCLUSIONS
  Assessment of renal function and lymphocyte count provide potentially useful information for the prognostic stratification in patients with ACS with no SSE (Arq Bras Cardiol. 2013; [online].ahead print, PP.0-0).
authors.affiliation: Hospital Português, Escola Bahiana de Medicina e Saúde Pública, Salvador, BA - Brazil. dalmeidajessica@gmail.com
authors.forename: Jessica Carolina Matos D'Almeida
authors.initials: JC
authors.lastname: Santos
authors.forename: Mário de Seixas
authors.initials: Mde S
authors.lastname: Rocha
authors.forename: Marcos da Silva
authors.initials: Mda S
authors.lastname: Araújo
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000401:mortality / Q000503:physiopathology; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis*; D003404:Creatinine / Q000097:blood*; D004812:Epidemiologic Methods; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D017052:Hospital Mortality; D006801:Humans; D006943:Hyperglycemia / Q000097:blood*; D007958:Leukocyte Count; D018655:Lymphocyte Count; D008297:Male; D009504:Neutrophils; D011379:Prognosis
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D003404:Creatinine