Correlation of white blood cells and its subtypes with different types of coronary heart disease and the clinical significance

AIM To explore the correlation of different types of coronary heart disease (CHD) with white blood cells, neutrophils, and neutrophil lymphocyte ratio (NLR), and to evaluate its clinical significance. METHODS A total of 1 058 CHD patients confirmed by coronary angiography were enrolled in the investigation. Patients were divided into an acute coronary syndrome (ACS) group (n=774) and a stable angina pectoris (SAP) group (n=284). The ACS patients were divided into 3 subgroups:an acute st-segment elevation myocardial infarction (STEMI) group (n=362), an acute non-st-segment elevation myocardial infarction (NSTEMI) group (n=136) and an unstable angina pectoris (UAP) group (n=276). The number of white blood cells and its subtypes (neutrophils and NLR) were compared between the ACS group and SAP group, and compared within 3 subgroups of the ACS (STEMI group, NSTEMI group and UAP group). The present investigaiton analyzed the correlation between peak of troponin, scope of narrow coronary artery and the related parameters of white blood cells, finally, calculated the cut of value to distinguish the subtypes of CHD using area under the ROC curve. RESULTS The total number of white blood cells, proportion of neutrophils, number of neutrophils and NLR in the ACS group were higher compared with the SAP group (P<0.05). These related parameters of white blood cells were higher in the STEMI group compared with the NSTEMI group and the UAP group (P<0.05 or P<0.01). The parameters in the NSTEMI group were higher than that of the UAP group (P<0.05 or P<0.01). The total number of white blood cells, number of neutrophils and NLR were positively correlated with peak of troponin (P<0.05); however, there was no correlation between these parameters and the scope of narrow coronary artery. The cut of value of NLR to distinguish ACS and SAP, STEMI and NSTEMI, MI and UAP were 3.00 (sensitivity 55.9%, specifity 85.0%), 4.90 (sensitivity 50.8%, specifity 82.4%), and 4.81(sensitivity 44.0%, specifity 91.7%), respectively. CONCLUSION The number of white blood cells and subtypes varied in different types of CHD. There was a positive correlation with peak of troponin. This correlation was not related to scope of narrow coronary artery and could be used to distinguish the subtypes of CHD accurately, especially the NLR.