Predictive value of peripheral neutrophil count on admission for young patients with acute coronary syndrome.

Objective: The present study aimed to explore the relationship between neutrophil count on admission and major adverse cardiovascular and cerebrovascular events (MACCE) and left ventricular ejection fraction (LVEF) during hospitalization in young ACS patients, which have rarely been investigated in previous studies.

Methods: This study included 400 young ACS patients (<45 years old) who underwent coronary angiography. According to the median neutrophil count at admission, the patients were divided into two groups. The relationship between neutrophil count and MACCE and LVEF during hospitalization was analyzed by regression analysis. The receiver operating characteristic (ROC) curve and the Youden index was used to determine the optimal cut-off value of neutrophil count.

Results: Neutrophil count at admission was an independent risk factor of in-hospital MACCE (OR: 1.33, 95 % CI: 1.13-1.56, P<0.001) and LVEF <50 % (OR: 1.28, 95 % CI: 1.12-1.47, P<0.001) in young ACS patients.The cutoff value of neutrophil count for predicting the occurrence of in-hospital MACCE was 6.935 × 10^⁹/L with a sensitivity of 92.1 %, specificity of 59.4 %, and AUC is 0.820 (95 % CI: 0.7587-0.8804, P<0.001), and for identifying the LVEF <50 % was 8.660 × 10^⁹/L with a sensitivity of 69.8 %, specificity of 76.8 %, and AUC is 0.775 (95 % CI: 0.6997-0.8505, P<0.001).

Conclusion: The neutrophil count upon admission is an independent predictor of in-hospital MACCE and LVEF in young ACS patients, giving important information for predicting the poor prognosis of young ACS patients.