Hematological indices as biomarkers to assess the cardiopulmonary complications of systemic sclerosis

Abstract

A multisystem disorder, systemic sclerosis (SSc) is distinguished by the collagen massive deposition in the skin, blood vessels, and various internal organs connective tissue, as well as microangiopathy, the immune system dysregulation, and significant morbidity and mortality due to cardiac and pulmonary involvement. This work aim was to investigate the haematological indices and cardiopulmonary involvement association in SSc, and their potential as predictor for pulmonary hypertension and interstitial lung disease. This Case-control study was performed on 56 individuals aged above 18 years old, both genders. Studied individuals were categorized into two groups (28 in each): cases group based on the SSc 2013 ACR/EULAR classification criteria and control group matched in age and sex. To lab investigation, medical history taking,, clinical examination, collecting data about regarding current therapeutic treatments, including GCs, MMF, MTX, CYC, RTX, PPI, vasodilators, and antiplatelet agents, was also recorded, and imaging [High-Resolution Computed Tomography, and Doppler Echocardiography] all cases were subjected . NLR shows AUC 0.944 with 0.787 to 0.996 (95% CI), indicating excellent discrimination ability and the cut-off value is > 1.6, with sensitivity of 94.4% and specificity of 100%, making it a strong predictor. While PLR shows AUC 1.00 with 0.877 to 1.000 (95% CI), indicating excellent discrimination ability and the cut-off value is > 99.4, with sensitivity and specificity at 100%, confirming strong statistical precision. The Blood indices, including the NLR and the PLR, serves as an indicator of subclinical inflammation, exhibiting elevated levels during exacerbations across various pulmonary conditions, including cancer, COPD, asthma, bronchiectasis, the severity of obstructive sleep apnea, obesity, and numerous cardiovascular disorders such as ischemic heart disease and myocardial infarction.