HEMATOLOGICAL PARAMETERS IN CARDIOVASCULAR DISEASES
Background: Cardiovascular diseases are one of the leading causes for morbidity and mortality worldwide. They are mainly caused by atherosclerosis and its complications. Limited literature is available on the role of various haematological parameters.Our objective was to study various haematological parameters like RBC count, Haemoglobin, Haematocrit, Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), RedCell Distribution Width (RDW) in patients with Coronary Artery Disease (CAD). Methods: This was a descriptive study carried out on patients with CAD admitted to Sri Jayadeva Institute of Cardiovascular Sciences and Research, KRHospital Campus, Mysore, India in the age range of 30â€“60 years. Patients with impaired renal or hepatic function, known congenital heart disease/valvular heart diseases, known case of anaemia or being treated for anaemia, prolonged drug intake, thyroid disorders were excluded from the study. Blood samples were collected in an EDTA vaccutainers and analysed in automated cell analysers. Results: About 26.7% of the patients were <40 years age, 31.7% between 41â€“50 years and 41.7% were in 51â€“60 year group; 28.3% were known patients of hypertension, while 43.3% had diabetes mellitus. Haemoglobin in 48.3% of the study population was within normal range, while 16.7% of them had low levels and 35% had higher levels. Eighty percent of them had normal RBC count, 15% had increased count and 5% had decreased count. Fifty percent subjects had normal PCV while 20% had increased and 30% had decreased values. There was increased RDW-SD and RDW-CV in 66.7% and 50% of the study population respectively. Conclusion: There is role of various parameters like haemoglobin, MCV, RDW in pathogenesis of CAD. Alterations in various haematological parameters over a long run may be one of the various other reasons for the development of CAD. Regular health check-ups with precautionary measures taken in advance may reduce the prevalence of the disease.
Pak J Physiol 2018;14(1):23â€“6
2. Wagner DD, Burger PC. Platelets in inflammation and thrombosis. Arterioscler Thromb Vasc Biol 2003;23:2131â€“7.
3. Wohner N. Role of cellular elements in thrombus formation and dissolution. Cardiovas Hematol Agents Med Chem 2008;3(6):224â€“8.
4. Schmid-Schonbein H, Roe Wells, Jerry Goldstone. Influence of deformability of human red cells upon blood viscosity. Circ Res 1969;25(2):131â€“43.
5. Goldsmith HL, Bell DN, Braovac S, Steinberg A, McIntosh F. Physical and chemical effects of red cells in the shear induced aggregation of human platelets. Biophys J 1995;69(4):1584â€“95.
6. Gersh KC, Nagaswami C, Weisel JW. Fibrin network structure and clot mechanical properties are altered by incorporation of erythrocytes. Thromb Haemost 2009;102(6):1169â€“75.
7. Whelihan MF, Mann KG. The role of the red cell membrane in thrombin generation. Thromb Res 2013;131(5):377â€“82.
8. Steptoe A, Wikman A, Molloy GJ, Kaski JC. Anaemia and the development of depressive symptoms following acute coronary syndrome: longitudinal clinical observational study. BMJ Open 2012;2(1):e 000551.
9. Toss F, Nordstrom A, Nordstrom P. Association between hematocrit in late adolescence and subsequent myocardial infarction in Swedish men. Int J Cardiol 2013;168:3588â€“93.
10. Gotoh S, Hata J, Ninomiya T, Hirakawa Y, Nagata M, Mukai N, et al. Hematocrit and the risk of cardiovascular disease in Japanese community: The Hisayama study. Atherosclerosis 2015;242(1):199â€“204.
11. Montagnana M, Cervellin G, Meschi T, Lippi G. The role of red blood cell distribution width in cardiovascular and thrombotic disorders. Clin Chem Lab Med 2011;50(4):635â€“41.
12. Tonelli M1, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M; for the Cholesterol and Recurrent Events (CARE) Trial Investigators. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulaion 2008;117(2):163â€“8.
13. Khode V, Sindhur J, Kanabur D, Ruikar K, Nallulwar S. Association of red blood cell distribution width, hematocrit and other RBC indices with Coronary Artery Disease: A case control study. Nig J Cardiol 2014;11:88â€“91.
14. Finch CA, Lenfant C. Oxygen transport in man. N. Engl J Med 1972;286:407â€“15.
15. Chonchol M, Neilson C. Hemoglobin levels and coronary artery disease. Am Heart J 2008;155(3):494â€“8.
16. Doganer YC, Rohrer JE, Aydogan U, Bernard ME, Barcin C. Hemoglobin levels correlate with the presence of coronary artery disease. J Eval Clin Pract 2015;21:937â€“42.
17. Wohner N. Role of cellular elements in thrombus formation and dissolution. Cardiovac Hematol Agents Med Chem 2008;6(3):224â€“8.
18. Weiss HJ, Lages B, Hoffmann T, Turitto VT. Correction of platelet adhesion defect in delta storage pool deficiency at elevated hematocrit, possible role of adenosine di phosphate. Blood 1996;87:4214.
19. Sprague RS, Ellsworth ML, Stephenson AH, Lonigro AJ. ATP: The red blood cell link to NO and local control of the pulmonary circulation. Am J Physiol 1996;271:H2717.
20. George A Mayer. Hematocrit and coronary heart disease. Can Med Assoc J 1965;93(22):1151â€“3.
21. Tulubas F, Gurel A, Akkoyun DC, Yilmaz A. MCV and MCH values in coronary artery patients with positive Gensini score. Eur J Gen Med 2013;10(3):131â€“5.
22. Felker GM, Allen LA, Pocock SJ, Shaw LK, McMurray JJ, Pfeffer MA, et al. CHARM Investigators. Red cell Distribution Width as a novel prognostic marker in heart failure. Data from the CHARM program and the Duke Databank. J Am Coll Cardiol 2007;50:40â€“7.
23. Sangoi MB, Guarda NDS, Rodel AP, Zorzo P, Borges PO, Cargnin LP, et al. Prognostic value of red cell distribution width in prediction of in hospital mortality in patients with acute myocardial infarction. Clin Lab 2014;60(8):1351â€“6.
24. Akin F, Kose N, Ayca B, Katkat F, Duran M, Uysal OK, et al. Relation between red cell distribution width and severity of coronary artery disease in patients with acute myocardial infarction. Angiology 2013;64(8):592â€“6.
25. Tanindi A, Topal FE, Topal F, Celik B. Red cell distribution width in patients with prehypertension and hypertension. Blood Press 2012;21(3):177â€“81.
26. Veeranna V, Zalawadiya SK, Panaich SS, Ramesh K, Alfonso L. The association of red cell distribution width with glycated hemoglobin among healthy adults without diabetes mellitus. Cardiology 2012;122(2):129â€“32.
Pakistan Journal of Physiology, Pak J Physiol, PJP is free for research and academic purposes. It can be downloaded and stored, printed, cited and quoted with full reference of, and acknowledgement to the PJP.