Evaluation of Clinical and Laboratory Predisposing Factors of Acute Coronary Syndrome in Military Staff

Background: Cardiovascular diseases are the leading cause of death in the third millennium. Acute coronary syndrome (ACS) is the most fatal cardiovascular disease, and various factors are involved in the development of this disease. These factors include clinical and laboratory factors as well as stress. Occupational stress is a risk factor for heart disease, and it also increases the risk of coronary heart disease. Military work is universally considered to be stressful. The aim of this study was to evaluate the clinical and laboratory predisposing factors of ACS in military staff. Methods: In this prospective study, 260 patients admitted to Baqiyatallah Hospital were enrolled and divided into 2 groups: 130 patients with ACS and 130 patients with stable coronary artery disease. The study population was studied for various variables, including occupational stress, sedentary lifestyle, and some laboratory markers, including the neutrophil-to-lymphocyte ratio (NLR), the ratio of monocytes to high-density lipoprotein (HDL), and red cell distribution width (RDW). Results: There were significant differences between the 2 groups in terms of physically demanding tasks (case: 61% vs control: 43%; P = 0.036), an average daily sitting time of more than 3 hours (case: 58.5% vs control: 43.8%; P = 0.048), and an average daily television watching time of more than 2 hours (case: 56.9% vs control: 42.3%; P = 0.048). There was a significant difference concerning NLR between the case and control groups (case: 4.8 ±1.4 vs control: 2.2 ± 0.5; P = 0.011) regarding the ratio of monocytes to HDL (case: 16.6 ± 5.6 vs control: 10.6 ± 3.1; P = 0.034) and RDW (case: 14.5 ± 1.9 vs control: 12.8 ± 1.4; P = 0.041). Conclusions: According to our findings, an increase in NLR and the ratio of monocytes to HDL are predisposing factors of ACS; in addition, RDW is a predicting factor of ACS in military personnel. A sedentary lifestyle and work stress are also contributing factors to the development of ACS in this population. (Iranian Heart Journal 2021; 22(1): 66-73)