White blood cell count to mean platelet volume ratio: A novel and promising prognostic marker for ST-segment elevation myocardial infarction

Background: Increased white blood cell (WBC) count is associated with increased mortality in patients with ST-segment elevation myocardial infarction (STEMI). We aimed to evaluate predictive value of admission WBC to mean platelet volume (MPV) ratio (WMR) on prognosis in patients undergoing primary percutaneous coronary intervention (pPCI) for STEMI. Methods: A total of 2,603 consecutive patients with STEMI who underwent pPCI were recruited for the study. Follow-up data were obtained from digital records, patient files or by telephone interview with patients, family members, or primary care physicians. Results: WMR has the highest area under receiver operating characteristic (ROC) curve and pairwise comparisons of the ROC curves revealed that WMR has the higher discriminative ability for long-term mortality than WBC, MPV, red blood cell distribution with (RDW), WBC-MPV combination, and platelet to lymphocyte ratio and neutrophil to lymphocyte ratio (PLR-NLR) combination in patients undergoing pPCI for STEMI (a WMR value of 1,653.47 was also found as threshold value for mortality with 75.4% sensitivity and 87.3% specificity by ROC curve analysis). Conclusions: Higher WMR value on admission was associated with worse outcomes in patients with STEMI and independently better predicted the long-term mortality than other complete blood count components, such as MPV, RDW, PLR-NLR and WBC-MPV combinations