Zhehestovska D. An optimized prediction strategy for complications of acute myocardial infarction based on the characteristics of leukocytes, platelets, and the von Willebrand factor to ADAMTS13 ratio

The thesis presents the prognostic value of leukocyte and platelet parameters of the complete blood count (CBC) and their ratios, as well as the levels of von Willebrand factor (vWF) and ADAMTS13 (A Disintegrin and Metalloproteinase with Thrombospondin in type 1) to predict the course of acute myocardial infarction (MI) that may occur during a hospital stay and after discharge. Based on the obtained results, the leading parameters predicting the development of complications during the hospital stay were selected, as well as risk groups that determine the probability of major adverse cardiac events (MACE) in the future. Significant laboratory markers of unfavorable course of MI have been identified, namely NLR, PLR, white blood cell count and vWF/ADAMTS13 ratio, based on generally accepted methods of statistical data processing. The relationship between the severity of coronary artery disease according to Gensini score and levels of vWF, as well as vWF/ADAMTS13 ratio was obtained. The existing information on the differences between the histological and clinical age of coronary thrombi, as well as the role of their morphological characteristics in predicting the further course of MI has been supplemented. It is proposed to use the ratios of leukocyte and platelet parameters such as PLR and NLR as markers of MI during a hospital stay, that significantly improve the accuracy of prognosis of complications of MI, especially in combination with the GRACE risk score. For the first time, a classification and regression tree algorithm was used using the parameters of complete blood count and vWF to ADAMTS13 ratio in order to predict complications of MI. Accordingly, risk groups for the development of MACE after discharge from the hospital were formed.