Early Identification of ST-Segment Elevation Myocardial Infarction (STEMI) at Presentation: Comparative…

StudyJournal of clinical medicine· May 2026

Early Identification of ST-Segment Elevation Myocardial Infarction (STEMI) at Presentation: Comparative Diagnostic Performance of CBC-Derived Inflammatory Indices and High-Sensitivity Troponin T.

Chennet Phonphet, Putrada Ninla-Aesong, Sasithorn Sanakus … Ladda Thiamwong

Acute Chest Pain & TroponinStudyDiagnosisQ2IF 3.5

NLPR blood marker shows highest sensitivity for detecting STEMI at first contact.

Early Identification of ST-Segment Elevation Myocardial Infarction (STEMI) at Presentation: Comparative Diagnostic Performance of CBC-Derived Inflammatory Indices and High-Sensitivity Troponin T.

Chennet Phonphet … Ladda Thiamwong

Journal of clinical medicine · May 2026 · Q2 in General Medicine

Background

Early identification of ST-segment elevation myocardial infarction (STEMI) at first medical contact remains challenging, as high-sensitivity troponin T may be insufficiently sensitive during the initial phase of myocardial injury.

Purpose

This study aimed to evaluate whether baseline complete blood count-derived inflammatory indices differ between STEMI and NSTEMI and whether they provide adjunctive discriminatory information at presentation (0 h) in patients with acute coronary syndrome (acute coronary syndrome).

Methods

A 12-lead electrocardiogram (electrocardiogram), high-sensitivity troponin T, and complete blood count were obtained at presentation from 252 patients with acute coronary syndrome (195 STEMI and 57 NSTEMI).

n = 252 patients

88.66%

Results

88.66%

NLPR catches most true STEMIs early, missing fewer than aNLR or troponin

n = 252 patients

More results

High-sensitivity troponin T demonstrated the highest specificity (84.44%) and positive predictive value (92.93%), supporting its role as a confirmatory biomarker; however, its low sensitivity (50.83%) and negative predictive value (29.92%) may reduce its utility during early assessment.

More results

In contrast, WBC and neutrophil counts demonstrated relatively favorable discriminatory performance at presentation (AUC > 0.72; Youden's index > 0.40).

NLR, SII, SIRI, and adjusted NLR showed moderate performance, with aNLR providing a balanced sensitivity (67.01%) and specificity (74.55%).

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Conclusion

Complete blood count-derived inflammatory indices, particularly neutrophil-based markers such as NLPR, may provide adjunctive discriminatory information during the early assessment of patients with acute coronary syndrome, particularly at first medical contact when baseline hs-Troponin T sensitivity may still be limited.

Early Identification of ST-Segment Elevation Myocardial Infarction (STEMI) at Presentation: Comparative Diagnostic Performance of CBC-Derived Inflammatory Indices and High-Sensitivity Troponin T.

Early Identification of ST-Segment Elevation Myocardial Infarction (STEMI) at Presentation: Comparative Diagnostic Performance of CBC-Derived Inflammatory Indices and High-Sensitivity Troponin T.

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