ABSTRACT:
Background: Coronary artery disease (CAD) had been a significant source of morbidity and mortality all over the world, and there are numerous hematological parameters that affected its development and evolution. How Hematocrit (Hct) level, one of the key measures of blood viscosity and oxygen-carrying capacity, influences coronary perfusion and plaque formation had been postulated. The high hematocrit levels may have contributed to high blood viscosity and shear stress and consequently facilitated endothelial dysfunction and atherogenesis, and low hematocrit levels may have resulted in the diminished oxygen supply of myocardial tissue. This relationship had played a crucial role in enhancing the process of cardiovascular risk assessment and management of patients.
Objective: The research sought to compare the extent of coronary artery disease in patients with different levels of hematocrit and whether hematocrit could be used as a predictive factor of the extent of CAD among patients who underwent coronary angiography.
Methods: This is an observational cross-sectional study that was carried out at AFIC/NIHD between February 2024 and October 2024. One hundred and thirty patients who had diagnostic coronary angiography due to the suspected ischemic heart disease were covered. The patients were divided into three categories according to the level of hematocrit: low (less than 38 percent), normal (38 to 48 percent) and high (greater than 48 percent). Hematocrit was assessed in automated hematology analysers and severity of CAD was assessed by the Gensini scoring system based on the results of the coronary angiography. The analysis of data was conducted with the help of the SPSS version 26, and the comparison of the hematocrit categories with the CAD severity score was conducted. Pearson correlation coefficient was used to determine the correlations between the hematocrit levels and Gensini scores and the p-value of below 0.05 was regarded to be statistically significant.
Results: The authors found that the level of hematocrit was significantly related to the severity of CAD ( p=0.05). The patients who had higher levels of hematocrit (>48%) exhibited more severe CAD with mean Gensini scores of 72.4 ± 18.6 as compared to those with normal hematocrit (51.2 ± 16.9) and low hematocrit (42.3 ± 14.7). The correlation between the hematocrit levels and the CAD severity showed positive correlation (r = 0.48, p<0.01) so that high levels of hematocrit were correlated to a higher atherosclerotic burden. Also, patients exhibiting high hematocrit levels exhibited higher chances of presenting with multivessel disease (67) than patients in the normal (45) and low (38) hematocrit.
Conclusion: The research concluded that there was a significant relationship between high level of hematocrit and high severity of coronary artery disease. Hematocrit, in turn, may be an easy, economical hematological parameter to help in risk stratification and early detection of patients who have a greater risk of severe CAD.
Keywords: Coronary artery disease, Hematocrit, Gensini score, Blood viscosity, Cardiovascular risk, Multivessel disease.