New platelet-derived ratios in acute coronary syndromes: a retrospective, single-center investigation

INTRODUCTION: Despite advancements in diagnostics and early risk assessments improving patient outcomes, the global death rate from acute coronary syndrome (ACS) continues to rise. Identifying new biomarkers holds promise for further care improvements. This study examined clinical and laboratory differences between ST-segment elevation myocardial infarction (STEMI) patients and non-ST-segment elevation myocardial infarction (NSTEMI) patients, focusing on the diagnostic value of platelet-derived ratios compared to other hematological parameters. MATERIAL AND METHODS: This is an observational, single-center study. The authors retrospectively collected patients with ACS who underwent invasive coronary angiography and a percutaneous coronary intervention between September 1 st , 2023, and December 31 st , 2023. Statistical analyses were performed to compare clinical and laboratory parameters between the STEMI and NSTEMI patient groups. RESULTS : The study included 65 patients (25 STEMI, 40 NSTEMI). White blood cell (WBC) count showed the highest discriminative power (AUC: 0.78, threshold: 10.56, sensitivity: 84%, specificity: 80%). (LDL-C) strongly correlated with total cholesterol (r = 0.96), and hemoglobin with hematocrit (r = 0.95). Moderate correlations were seen between WBC and (PLT) (r = 0.52) and PLT with the PLT-to-WBC ratio (r = 0.38). PLT-to-total cholesterol correlated negatively with cholesterol (r = –0.63), while hemoglobin correlated negatively with PLT-to-hemoglobin (r = –0.34). The platelet-to-hematocrit ratio, with an area under the curve (AUC) of 0.60, showed balanced discriminative capacity (sensitivity: 48%, specificity: 80%). CONCLUSIONS: Present findings demonstrate platelet-derived ratios' ability to distinguish STEMI from NSTEMI. The platelet-to-hematocrit ratio was the most discriminative composite metric. To improve acute coronary syndrome diagnosis and prognosis, platelet levels should be correlated with other hematological parameters.