Analysis of the predictive potential of hematological parameters for obstructive coronary artery disease in patients with stable ischemic heart disease

Introduction. Low frequency of obstructive coronary artery disease (OCAD) detection during invasive coronary angiography in patients with stable ischemic heart disease (30–58 %) indicates the need to improve preoperative risk stratification methods using available hematological parameters. Aim. To analyze the predictive potential of hematological parameters for developing prognostic models of obstructive coronary artery disease in patients with stable ischemic heart disease. Materials and methods. A single-center retrospective cohort study was conducted in 1,005 patients (687 men and 318 women) with stable ischemic heart disease, median age 65.2 [60;72] years, who have had invasive coronary angiography. We analyzed 53 demographic, clinical and laboratory parameters, including hematological indices of inflammatory response (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, and neutrophil-to-eosinophil ratio), metabolic indices (atherogenic index of plasma, triglyceride-glucose index, etc.), and hemostasis parameters. Mathematical statistics methods, such as Mann-Whitney test, chi-square test, Fisher’s exact test, and univariate logistic regression, and machine learning methods, such as multivariate logistic regression, were used to develop prognostic models. The study endpoint was represented by the hemodynamically significant (>50%) narrowing of the epicardial coronary artery lumen. Results and Discussion. Obstructive coronary artery disease was detected in 774 (77%) patients, and non-obstructive lesions in 231 (23%) patients. Statistically significant differences between groups were identified for 17 parameters, among which the following demonstrated the greatest predictive potential: Neutrophil-to-high-density-lipoprotein-cholesterol ratio >2.38 (odds ratio = 3.2), eosinophils 0.85–2.5% (odds ratio = 2.8), fibrinogen-to-international-normalized-ratio >3.63 (odds ratio = 2.44), and neutrophil-to-eosinophil ratio 53%, white blood cells >6.23×10 9 /L, fibrinogen >3.52 g/L, high-density lipoprotein cholesterol