A multidimensional approach to assess cardiovascular disease risk combining biochemical, hematological, lipid ratios, atherosclerotic cardiovascular disease, and WHO/ISH 10-year risk estimators: a cross-sectional study.

Cardiovascular disease (CVD), a leading global health concern and the primary cause of death worldwide, is often associated with atherosclerosis and cardiac events.

objectiveThis study evaluated biochemical and hematological parameters as predictors of CVD risk using atherosclerotic CVD and World Health Organization/International Society of Hypertension risk scores (WHO/ISH). METHODOLOGY: 102 volunteer participants representing 69 males (67.6%) and 33 females (32.4%) from the Health and Administrative Staff of University Hospital-General Sir John Kotelawala Defence University, Sri Lanka, were selected. Patient demographics, biometrics, clinical parameters, and behavioral risk factors were collected. Laboratory parameters: complete blood count, lipid profile, aspartate and alanine aminotransferases were performed. The 10-year CVD risk was estimated using the "ASCVD-Risk Estimator-Plus" and WHO/ISH risk score charts; South Asia and Southeast Asia. The data were analyzed using IBM-SPSS-version26.

resultsThe study population showed strong to moderate-strong correlations within the hematological, biochemical, and risk estimators, but not between these parameters. Platelets-to-Lymphocytes Ratio (PLR) had a strong, significant positive correlation with the Neutrophils-to-Lymphocyte Ratio (NLR) and a moderately strong, significant positive correlation with Platelets and NLR (r=0.446; P<0.001), indicating the inflammatory response, atherosclerosis with increased CVD risk. In the regression analysis, the HDL-LDL ratio was found to independently predict the TC-HDL ratio and successfully combined the WHO/ISH risk estimators with the collected biochemical, hematological, clinical, biometric, and behavioral risk factors by introducing highly predictive, well-fit equations. The ROC analysis indicated that once the HDL-LDL-ratio reduces below 0.39, ASCVD-10-year-risk (ASCVD_10) and ASCVD-lifetime-risk (ASCVD_LT) increase to 4.95 and 37.5, respectively.

conclusionA strong positive correlation was found between NLR, PLR, and CVD risk, with a moderate correlation between PLT and NLR. ASCVD_10 showed a reliable link with ASCVD_OP and ASCVD_LT, marking the first comparison of all three risk types. Predictive equations were developed by integrating WHO/ISH scores and other parameters. The TC-HDL ratio significantly correlated with the HDL-LDL ratio, enabling a cut-off value to predict ASCVD_10 risk and associated hematological and biochemical markers.