Hematological parameters and major adverse cardiovascular events: a prospective study in a Chinese population involving 2,970 participants

Hematological parameters are among the most accessible and routinely performed clinical tests. Recent studies have gradually revealed their potential for risk prediction. This study aimed to assess the association between hematological parameters and major adverse cardiovascular events (MACEs) in patients with coronary artery disease. This prospective study included 2,970 Chinese participants who underwent coronary angiography, with hematological and biochemical indicators measured at baseline. MACEs, comprising myocardial infarction, stroke, revascularization, and all-cause mortality, were recorded during follow-up. Univariate and multivariate analyses were conducted to evaluate the relationship between the hematological parameters and MACEs. Over a median follow-up period of 79 months, 474 MACEs were documented. Kaplan-Meier analysis indicated that the participants with lower levels of RBC, PLT, PCT, LYMPH% and BASO%, as well as higher RDW-CV, RDW-SD, MONO% and NEUT%, exhibited reduced survival probability. Multivariate Cox regression analysis identified elevated RDW-CV as a significant risk factor for MACE (T3 HR, 1.292; 95% CI, 1.013-1.647; <i>P</i>=0.039), while lower BASO% demonstrated a protective effect (T3 HR, 0.750, 95 % CI: 0.591-0.953; <i>P</i>=0.018). LYMPH% also showed a significant association with MACEs. Additionally, nonlinear correlations were observed between PLT and PCT and MACEs. In conclusion, RDW-CV, BASO%, PLT, PCT and LYMPH% were closely associated with MACEs and may serve as potential predictors for cardiovascular risk in patients with coronary artery disease.