Evaluating the association of ischemic ECG changes and CBC parameters in normal population

ARYA Atheroscler. 2025;21(4):15-25. doi: 10.48305/arya.2025.43555.3038.

Abstract

Background: Finding the relation between complete blood count (CBC) parameters and ischemic electrocardiogram (ECG) changes among a large normal population, for the first time.

Methods: Participants of the first phase of the MASHAD cohort study were enrolled in this cross-sectional study. Twelve-lead ECGs were taken from participants. According to the Minnesota codes, we divided the ischemic ECG changes into major and minor. Major ischemic changes included major Q-wave changes, minor Q-wave plus ST-T changes, and major isolated ST-T changes. Minor changes included minor isolated Q/QS waves, minor ST/T changes, and ST-segment elevation. The mean of the CBC parameters was compared between individuals with and without ischemic changes. The backward stepwise logistic regression model was implemented to estimate the odds ratios of ECG changes and eliminate confounders. Data were analyzed using SPSS version 20, with significance set at p < 0.05.

Results: Among 9,106 participants, 510 individuals (5.6%) had minor and major ischemic changes, with a preference for males. Major ischemic changes were not associated with CBC parameters. However, the odds of having minor ischemic changes increased 1.96-fold with increasing red blood cell (RBC) count (OR = 1.96 [1.31-2.94], p = 0.001); though, they decreased by 0.18 units with increasing hemoglobin (OR = 0.81 [0.73-0.92], p = 0.001). Additionally, high mean corpuscular volume (MCV) increased the odds of minor ischemic changes (OR = 1.05 [1.01-1.08], p = 0.004).

Conclusion: Among Mashhad's normal population, major ischemic changes were not associated with CBC parameters. Also, minor and major ischemic changes were positively associated with WBC count.

Keywords: Cardiovascular Disease; Complete Blood Count; Electrocardiogram.