Neutrophil precursors in complete blood count: innovative biomarker for acute pulmonary embolism severity

Background: Inflammation plays an important role in the pathogenesis of acute pulmonary embolism (APE), which is a cardiovascular emergency associated with high mortality. The primary determinant of the clinical course in the setting of APE is right ventricular dysfunction (RVD). In this study, we aim to investigate the usefulness of circulating immature granulocytes (IG) as an inflammatory biomarker in predicting RVD in APE. Methods: We retrospectively analyzed data of 59 patients admitted to the emergency department between January 2019 and June 2022, diagnosed with APE. A complete blood count at admission determined the IG count. According to their echocardiographic evaluation, patients were divided into two groups according to the presence of RVD. Results: We observed in APE that the mean IG count was significantly higher in patients with RVD than those without RVD (p =0.001). The multivariate logistic regression analysis detected a significant (p =0.006) and independent effect of the IG count in distinguishing cases with and without RVD. Conclusions: We found the discriminative effectiveness of the IG 0.05 cut-off value for RVD. IGs, an inflammatory precursor obtained readily and without additional cost as part of a complete blood count, may be a new and valuable biomarker for risk stratification and prognosis assessment by predicting RVD in APE patients. HIPPOKRATIA 2025, 29 (1):20-24.