Generic placeholder image

Current Cardiology Reviews


ISSN (Print): 1573-403X
ISSN (Online): 1875-6557

Review Article

Hematological Parameters as Prognostic Biomarkers in Patients with Cardiovascular Diseases

Author(s): José Gildo de Moura Monteiro Júnior*, Dilênia de Oliveira Cipriano Torres and Dário Celestino Sobral Filho

Volume 15, Issue 4, 2019

Page: [274 - 282] Pages: 9

DOI: 10.2174/1573403X15666190225123544


Cardiovascular diseases are the major causes of preventable health loss from disease in the world and lead to functional disturbances including hematological parameters. The inflammatory and hypoxemic nature of cardiovascular diseases causes a stimulus in the bone marrow and, depending on the intensity of this stimulus, there is a release of immature cells or increase of other cells in the bloodstream. Therefore, their presence in the circulation is an important variable used to diagnose, stratify and predict diseases.

In the last five decades, with the advent of automated counting of immature cells in the peripheral blood, the hemogram was transformed into a clinical tool of great importance in hospital surveillance for demonstrating this daily variability in the hematopoietic response according to the existing injury in the patient. Studies have shown that the presence of nucleated red blood cells and increases in mean platelet volume, immature granulocytes and neutrophil to lymphocyte ratio in the systemic circulation are independent prognostic biomarkers.

This review article has as main objective to demonstrate the association of these hematological parameters to cardiovascular diseases, emphasizing their importance in clinical decision making.

Keywords: Nucleated red blood cells, neutrophil to lymphocyte ratio, mean platelet volume, immature granulocytes, biomarkers, cardiovascular diseases.

Graphical Abstract
Thomas H, Diamond J, Vieco A, et al. Global atlas of cardiovascular disease 2000-2016: The path to prevention and control. Glob Heart 2018; 13(3): 143-63.
Li L, Xie W, Zheng X, Yin W, Tang C. A novel peptide adropin in cardiovascular diseases. Clin Chim Acta 2016; 453: 107-13.
Monteiro Júnior JGM, Torres DOC, Silva MCFC, et al. Nucleated red blood cells as predictors of all-cause mortality in cardiac intensive care unit patients: A prospective cohort study. PLoS One 2015; 10(12)e0144259
Verbrugge SE, Huisman A. Verification and standardization of blood cell counters routine clinical laboratory tests. Clin Lab Med 2015; (35): 183-96.
Fan L, Gui L, Chai EQ, Wei CJ. Routine hematological parameters are associated with short- and long-term prognosis of patients with ischemic stroke. J Clin Lab Anal 2018. Epub Ahead of Print
Söderholm M, Borné Y, Hedblad B, Persson M, Engström G. Red cell distribution width in relation to incidence of stroke and carotid atherosclerosis: A population-based cohort study. PLoS One 2015; 10(5)e0124957
Budziannowski J, Pieszko K, Burchardt P, Rzezniczak J, Hiczkiewicz J. The role of hematological indices in patients with acute coronary syndrome. Dis Markers 2017; 20173041565
Monteiro Júnior JGM, Torres DOC, da Silva MCFC, et al. Prognostic value of hematological parameters in patients with acute myocardial infarction: Intrahospital outcomes. PLoS One 2018; 13(4)e0194897
Wan G, Ji L, Xia W, Cheng L, Zhang Y. Screening genes associated with elevated neutrophiltolymphocyte ratio in chronic heart failure. Mol Med Rep 2018; 18(2): 1415-22.
Liu S, Wang P, Shen PP, Zhou JH. Predictive values of red blood cell distribution width in assessing severity of chronic heart failure. Med Sci Monit 2016; 22: 2119-25.
Emamian M, Hasanian SM, Tayefi M, et al. Association of hematocrit with blood pressure and hypertension. J Clin Lab Anal 2017; 31(6) Epub Ahead of Print
Enawgaw B, Adane N, Terefe B, Asrie F, Melku M. A comparative cross-sectional study of some hematological parameters of hypertensive and normotensive individuals at the university of Gondar hospital, Northwest Ethiopia. BMC Hematol 2017; 17: 21.
Weymann A, Ali-Hasan-Al-Saegh S, Popov AF, et al. Hematological índices as predictors of atrial fibrillation following isolated coronary artery by-pass grafting, valvular surgery or combined procedures: A systematic review with meta-analysis. Kardiol Pol 2018; 76(1): 107-18.
Musher DM, Abers MS, Corrales-Medina VF. Acute infection and myocardial infarction. N Engl J Med 2019; 380(2): 171-6.
Lecompte TP, Bernimoulin MP. Novel parameters in blood cell counters. Clin Lab Med 2015; (35): 209-24.
Guyton AC, Hall JE. Textbook of Medical Physiology, 11th edition editing in Portuguese by Elsevier 2006; ISBN 978-85-352-1641-7; 32: 419-28; 33:429-38; 36:. 457-68.
Machlus KR, Italiano JE Jr. The incredible journey: From megakaryocyte development to platelet formation. J Cell Biol 2013; 201(6): 785-96.
Green R, Wachsmann-Hogiu S. Development, history, and future of automated cell counters. Clin Lab Med 2015; 35(1): 1-10.
Stachon A, Sebbers E, Holland-Letz T, Kempf R, Herinf S, Krieg M. Nucleated red blood cells in the blood of medical intensive care patients indicate increased mortality risk: A prospective cohort study. Crit Care 2007; 11: R62.
Desai S, Jones SL, Turner KL, Hall J, Moore LJ. Nucleated red blood cells are associated with a higher mortality rate in patients with surgical sepsis. Surg Infect 2012; 13(6): 360-5.
Kuert S, Holland-Letz T, Friese J. stachon A. association of nucleated red blood cells in blood and arterial oxygen partial tension. Clin Chem Lab Med 2011; 49(2): 257-63.
Felker GM, Allen LA, Pocock SJ, et al. Red distribution width as a novel prognostic marker in heart failure. J Am Coll Cardiol 2007; 50(1): 40-7.
Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation 2008; 117(2): 163-8.
Baskurt OK, Meiselman HJ. Erythrocyte aggregation: Basic aspects and clinical importance. Clin Hemorheol Microcirc 2013; 53(1-2): 23-37.
Ami RB, Barshtein G, Zeltser D, et al. Parameters of red blood cell aggregation as correlates of the inflammatory state. Am J Physiol Heart Circ Physiol 2001; 280(5): H1982-8.
Tikhomirova IA, Oslyakova AO, Mikhailova SG. Microcirculation and blood rheology in patients with cerebrovascular disorders. Clin Hemorheol Microcirc 2011; 49: 295-395.
Koscielny J, Jung EM, Mrowietz C, Kiesewetter H, Latza R. Blood fluidity, fibrinogen, and cardiovascular risk factors of occlusive arterial disease: Results of the Aachen study. Clin Hemorheol Microcirc 2004; 31(3): 185-95.
Packard RRS, Libby P. Inflamation in atherosclerosis: From vascular biology to biomarker discovery and risk prediction. Clin Chem 2008; 54(1): 24-38.
Zazula AD, Précoma-Neto D, Gomes AM, et al. Avaliação da relação neutrófilos/linfócitos em pacientes com suspeita de síndrome coronariana aguda. Arq Bras Cardiol 2008; 90(1): 31-6.
Association between the Neutrophil / Lymphocyte Ratio and the Degree of Electrocardiographic Ischemia in the STEMI. Arq Bras Cardiol 2015; 104(2): 112-9.
Núñez J, Núñez E, Bodí V, et al. Low lymphocyte count in acute phase of ST-segment elevation myocardial infarction predicts long-term recurrent myovardial infarction. Coron Artery Dis 2010; 21: 1-7.
Basem A, Zaher M, Weiserbs KF, et al. Usefulness of neutrophil to lymphocyte ratio in predicting short and long-term mortality after non-ST elevation myocardial infarction. Am J Cardiol 2010; 106(4): 470-6.
Uysal HB, Dagli B, Akgullu C, et al. Blood count parameteres can predict the severity of coronary artery disease. Korean J Intern Med 2016; 31: 1093-100.
Verdoia M, Barbieri L, Di Giovine G, et al. Neutrophil to lymphocyte ratio and the extent of coronary artery disease: Results from a large cohort study. Angiology 2016; 67(1): 75-82.
Kaya H, Ertas F, Islamoglu Y, et al. Association between neutrophil to lymphocyte ratio and severity of coronary artery disease. Clin Appl Thromb Hemost 2014; 20(1): 50-4.
Larsen SB, Grove EL, Hvas AM, Kristensen SD. Platelet turnover in stable coronary artery disease – influence of thrombopoietin and low-grade inflamation. PLoS One 2014; 9(1)e85566
Grove EL, Hvas AM, Mortensen SB, Larsen SB, Kristensen SD. Effect of platelet turnover on whole blood platelet aggregation in patients with coronary artery disease. J Thromb Hemost 2011; 9: 185-91.
Wendland AE, Farias MG, Manfroi WC. Volume plaquetário médio e doença cardiovascular. J Brasileiro Patologia Medicina Laboratorial 2009; 45(5): 371-8.
Puertas M, Zayas-Castro JL, Fabri PJ. Statiscal and prognostic analysis of dynamic changes of platelet count in ICU patients. Physiol Meas 2015; 36: 939-53.
Greinacher A, Selleng K. Thrombocytopenia in the intensive care unit patient. Hematology 2010; 2010: 135-43.
Labriolle AD, Bonello L, Lemesle G, et al. Decline in platelet count in patients treated by percutaneous coronary intervencion: Defition, incidence, prognostic importance, and predictive factors. Eur Heart J 2010; 31(9): 1079-87.
Monteiro Júnior JGM, Torres DOC, Silva MCFC, et al. Evaluation of platelet parameters as prognostic analysis in cardiac intensive care units patients. Atherosclerosis 2017; 2: 1.
Murat SN, Duran M, Kalay N, et al. Relation between mean platelet volume and severity of atherosclerosis in patients with acute coronary syndromes. Angiology 2013; 64(2): 131-6.
Klovaite J, Benn M, Yazdanyar S, Nordestgaard BG. High platelet volume and increased risk of myocardial infarction: 39,531 participants from the general population. J Thromb Hemost 2011; 9(1): 49-56.
Ibrahim H, Schutt RC, Hannawi B, DeLao T, Barker CM, Kleiman NS. Association of immature platelets with adverse cardiovascular outcomes. J Am Coll Cardiol 2014; 2014: 2122-9.
Bernlochner I, Goedel A, Plischke C, et al. Impact of immature platelets on platelet response to ticagrelor and prasugrel in patients with acute coronary syndrome. Eur Heart J 2015; 36: 3202-10.
Grove EL, Hvas AM, Mortensen SB, Larsen SB, Kristensen SD. Effect of platelet turnover on whole blood platelet aggregation in patients with coronary artery disease. J Thromb Haemost 2011; 9: 185-91.
Buttarello M, Plebani M. Automated blood cell counts: State of the art. Am J Clin Pathol 2008; 130(1): 104-16.
Ansari-Lari MA, Kickler TS, Borowitz MJ. Immature granulocyte measurement using the Sysmex XE-2100. Relationship to infection and sepsis. Am J Clin Pathol 2003; 120(5): 795-9.
Dellinger RP, Levy MM, Rhodes A, et al. Surviving sepsis campaign: Internacional guidelines for management of severe sepsis and septic shock 2012. Intensive Care Med 2013; 39(2): 165-228.

© 2024 Bentham Science Publishers | Privacy Policy