الفهرس 
ACUTE CORONARY SYNDROMEOnly 14 pages are availabe for public view
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Abstract
A
cute coronary syndrome (ACS) is a manifestation of coronary artery disease (CAD) and includes acute myocardial infarction (AMI) and unstable angina pectoris (UA). Coronary artery disease results from a complex process known as atherosclerosis. Atherosclerotic plaque formation is built up not only from cholesterol but also inflammatory response may be present in plaques.
Since understanding the role of inflammation in the atherosclerosis process is increasing, so a large number of studies have focused on the research of inflammatory markers to assess the risk of acute coronary syndrome.
This study aims to determine the role of NLR, CRP and MPV as important markers in acute coronary syndrome, these relatively inexpensive and very available parameters can be of great importance and help to establish the correct diagnosis in patients with ACS.
All patients were subjected to history taking to confirm that all included patients satisfied the inclusion and exclusion criteria. All patients had a blood sample taken for evaluation of WBCs count, NLR, CRP, MPV, platelet count and cardiac enzymes.
Our study showed a statistically significant difference between ACS patients and healthy control group as regard NLR, CRP and MPV level.
In our study, there was statistically significant difference among subgroups as regard NLR indicating its importance in discriminating the clinical forms of ACS and assessing the degree of myocardial lesion intensity while there was no statistically significant difference among subgroups as regard CRP and MPV level.
A positive correlation was found between NLR and markers of myocardial damage in our study.
Measurement of CRP, NLR and MPV is simple, inexpensive and non-invasive which can play a major role in diagnosis of ACS patients.
The NLR can be used to discriminate the clinical forms of ACS and also can assess the degree of myocardial lesion intensity.
MPV might be useful as an assisting rule-out test with other conventional biochemical cardiac markers in the early prediction of the risk of ACS in patients admitted to the emergency department. MPV is a simple and costless laboratory measurement that is obtained with complete blood count.
CRP can be used as an important marker in diagnosis and risk stratification of ACS patients.
RECOMMENDATIONS
● Further studies with larger scale should be done, including large number of patients.
● Serial measurement of these markers not only on hospital admission to assess change over time, predict the prognosis and to assess early treatment response in hospitalized patients.
● Other markers can be added in conjugation with our markers to increase their sensitivity and specificity.
● Patients in the STEMI sub-group were higher compared with the NSTEMI/UA subgroups thus equal sub-groups of ACS are recommended to be enrolled in future studies.