{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T12:21:16Z","timestamp":1789042876295,"version":"build-2803163510"},"reference-count":35,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,6,15]],"date-time":"2025-06-15T00:00:00Z","timestamp":1749945600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Cardiovascular diseases continue to pose a major global health burden, contributing significantly to mortality rates worldwide. This study aimed to explore the association between myocardial infarction and basic hematological parameters\u2014red blood cells (RBCs), white blood cells (WBCs), and platelets (PLTs)\u2014which are routinely assessed in clinical diagnostics. The analysis was conducted on a cohort of 743 adults hospitalized with diagnosed cardiovascular conditions. To identify blood parameters that distinguish patients with a history of first-time myocardial infarction from those who had never experienced such an event, we employed a dual analytic approach. Standard parametric methods were complemented with bootstrap resampling to strengthen inference and mitigate the impact of sampling variability. Patients with myocardial infarction showed decreased RBC and elevated WBC counts relative to those without infarction. These associations were non-linear, with the most pronounced group differences observed within the second and third quartiles of RBC and WBC distributions, while minimal differences appeared at the distributional extremes. No significant differences were found in platelet count (PLT) between the groups. Bootstrap validation not only corroborated findings obtained through traditional statistics, but also enhanced the robustness of the results, providing improved estimates under data conditions prone to skewness or small sample artifacts. This approach enabled the detection of nuanced patterns that might elude classical inference. Our findings emphasize the utility of resampling techniques in clinical research settings, particularly where inference stability is critical. Incorporating such methods in future investigations may advance statistical rigor, increase reproducibility, and better capture complex biological relationships in medical datasets.<\/jats:p>","DOI":"10.3390\/ijms26125736","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T10:47:22Z","timestamp":1750070842000},"page":"5736","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Red Blood Cell, White Blood Cell, and Platelet Counts as Differentiating Factors in Cardiovascular Patients with and Without Current Myocardial Infarction"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7979-9641","authenticated-orcid":false,"given":"Joanna","family":"Kostanek","sequence":"first","affiliation":[{"name":"Department of Haemostatic Disorders, Medical University of Lodz, 6\/8 Mazowiecka Street, 92-215 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamil","family":"Karolczak","sequence":"additional","affiliation":[{"name":"Department of Haemostatic Disorders, Medical University of Lodz, 6\/8 Mazowiecka Street, 92-215 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiktor","family":"Kuliczkowski","sequence":"additional","affiliation":[{"name":"Institute for Heart Diseases, Wroclaw Medical University, 213 Borowska Street, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5627-7872","authenticated-orcid":false,"given":"Cezary","family":"Watala","sequence":"additional","affiliation":[{"name":"Department of Haemostatic Disorders, Medical University of Lodz, 6\/8 Mazowiecka Street, 92-215 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.1016\/S1474-5151(11)00111-3","article-title":"The global burden of cardiovascular disease","volume":"10","author":"Deaton","year":"2011","journal-title":"Eur. J. Cardiovasc. Nurs."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2361","DOI":"10.1016\/j.jacc.2022.11.005","article-title":"The Global Burden of Cardiovascular Diseases and Risk: A Compass for Future Health","volume":"80","author":"Vaduganathan","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1007\/s12013-015-0553-4","article-title":"Myocardial Infarction: Symptoms and Treatments","volume":"72","author":"Lu","year":"2015","journal-title":"Cell Biochem. Biophys."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Seo, I.H., and Lee, Y.J. (2022). Usefulness of Complete Blood Count (CBC) to Assess Cardiovascular and Metabolic Diseases in Clinical Settings: A Comprehensive Literature Review. Biomedicines, 10.","DOI":"10.3390\/biomedicines10112697"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Huilcaman, R., Venturini, W., Fuenzalida, L., Cayo, A., Segovia, R., Valenzuela, C., Brown, N., and Moore-Carrasco, R. (2022). Platelets, a Key Cell in Inflammation and Atherosclerosis Progression. Cells, 11.","DOI":"10.3390\/cells11061014"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"6902","DOI":"10.1038\/s41467-024-50994-7","article-title":"A Platelet Reactivity ExpreSsion Score derived from patients with peripheral artery disease predicts cardiovascular risk","volume":"15","author":"Berger","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1038\/s41577-021-00584-1","article-title":"How the immune system shapes atherosclerosis: Roles of innate and adaptive immunity","volume":"22","author":"Roy","year":"2022","journal-title":"Nat. Rev. Immunol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1016\/j.jacc.2004.07.056","article-title":"Leukocyte count and coronary heart disease: Implications for risk assessment","volume":"44","author":"Madjid","year":"2004","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1177\/2047487316672004","article-title":"Plasma and blood viscosity in the prediction of cardiovascular disease and mortality in the Scottish Heart Health Extended Cohort Study","volume":"24","author":"Peters","year":"2017","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2943","DOI":"10.1182\/blood-2005-10-3992","article-title":"Red blood cells express a functional endothelial nitric oxide synthase","volume":"107","author":"Kleinbongard","year":"2006","journal-title":"Blood"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1111\/jth.14360","article-title":"Red blood cells: The forgotten player in hemostasis and thrombosis","volume":"17","author":"Weisel","year":"2019","journal-title":"J. Thromb. Haemost."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Nader, E., Skinner, S., Romana, M., Fort, R., Lemonne, N., Guillot, N., Gauthier, A., Antoine-Jonville, S., Renoux, C., and Hardy-Dessources, M.D. (2019). Blood rheology: Key parameters, impact on blood flow, role in sickle cell disease and effects of exercise. Front. Physiol., 10.","DOI":"10.3389\/fphys.2019.01329"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1214\/aos\/1176344552","article-title":"Bootstrap Methods: Another Look at the Jackknife","volume":"7","author":"Efron","year":"1979","journal-title":"Ann. Stat."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1177\/1076029613492009","article-title":"The relationship of acute myocardial infarction with or without ST-segment elevation and viscosity","volume":"20","author":"Kul","year":"2014","journal-title":"Clin. Appl. Thromb.\/Hemost."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1002\/clc.24108","article-title":"Red blood cell count and risk of adverse outcomes in patients with mildly reduced left ventricular ejection fraction","volume":"46","author":"Liu","year":"2023","journal-title":"Clin. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.freeradbiomed.2021.03.020","article-title":"Novel perspectives on redox signaling in red blood cells and platelets in cardiovascular disease","volume":"168","author":"Mahdi","year":"2021","journal-title":"Free Radic. Biol. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1093\/cvr\/cvz156","article-title":"Red blood cell dysfunction: A new player in cardiovascular disease","volume":"115","author":"Pernow","year":"2019","journal-title":"Cardiovasc. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1038\/35054560","article-title":"Export by red blood cells of nitric oxide bioactivity","volume":"409","author":"Pawloski","year":"2001","journal-title":"Nature"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Gajecki, D., Gawry\u015b, J., Szahidewicz-Krupska, E., and Doroszko, A. (2022). Role of Erythrocytes in Nitric Oxide Metabolism and Paracrine Regulation of Endothelial Function. Antioxidants, 11.","DOI":"10.3390\/antiox11050943"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"4229","DOI":"10.1182\/blood-2012-07-442277","article-title":"Human red blood cells at work: Identification and visualization of erythrocytic eNOS activity in health and disease","volume":"120","author":"Sansone","year":"2012","journal-title":"Blood"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s12291-011-0108-4","article-title":"Biochemistry of nitric oxide","volume":"26","author":"Habib","year":"2011","journal-title":"Indian J. Clin. Biochem."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.redox.2013.12.027","article-title":"Endothelial nitric oxide synthase in red blood cells: Key to a new erythrocrine function?","volume":"2","author":"Kelm","year":"2014","journal-title":"Redox Biol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1007\/s00395-022-00953-4","article-title":"Erythrocytes from patients with ST-elevation myocardial infarction induce cardioprotection through the purinergic P2Y13 receptor and nitric oxide signaling","volume":"117","author":"Jiao","year":"2022","journal-title":"Basic Res. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e167693","DOI":"10.1172\/JCI167693","article-title":"Hypoxic erythrocytes mediate cardioprotection through activation of soluble guanylate cyclase and release of cyclic GMP","volume":"133","author":"Yang","year":"2023","journal-title":"J. Clin. Investig."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1161\/01.CIR.51.6.1079","article-title":"Observations on blood viscosity changes after acute myocardial infarction","volume":"51","author":"Jan","year":"1975","journal-title":"Circulation"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.amjcard.2008.03.026","article-title":"Comparison of hemorheological variables in ST-elevation myocardial infarction versus those in non-ST-elevation myocardial infarction or unstable angina pectoris","volume":"102","author":"Cecchi","year":"2008","journal-title":"Am. J. Cardiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1620\/tjem.249.65","article-title":"High hematocrit levels are associated with risk of cardiovascular mortality among middle-aged Japanese women: The Ibaraki Prefectural Health Study (IPHS)","volume":"249","author":"Takaoka","year":"2019","journal-title":"Tohoku J. Exp. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1002\/jcla.21767","article-title":"Relationship between hematocrit level and cardiovascular risk factors in a community-based population","volume":"29","author":"Jin","year":"2015","journal-title":"J. Clin. Lab. Anal."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Lassale, C., Curtis, A., Abete, I., van der Schouw, Y.T., Verschuren, W.M.M., Lu, Y., and Bueno-de-Mesquita, H.B.A. (2018). Elements of the complete blood count associated with cardiovascular disease incidence: Findings from the EPIC-NL cohort study. Sci. Rep., 8.","DOI":"10.1038\/s41598-018-21661-x"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Goyal, A., Belur, A.D., Dey, A.K., and Mehta, N.N. (2019). Blood inflammatory biomarkers of cardiovascular disease. Biomarkers in Cardiovascular Disease, Elsevier.","DOI":"10.1016\/B978-0-323-54835-9.00007-7"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.amjcard.2023.06.119","article-title":"The prognostic significance of leukocyte count on all-cause and cardiovascular disease mortality: A systematic review and meta-analysis","volume":"203","author":"Park","year":"2023","journal-title":"Am. J. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.1016\/j.amjcard.2005.12.044","article-title":"Usefulness of combined white blood cell count and plasma glucose for predicting in-hospital outcomes after acute myocardial infarction","volume":"97","author":"Ishihara","year":"2006","journal-title":"Am. J. Cardiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.5114\/amsad.2016.60759","article-title":"Correlation between leukocyte count and infarct size in ST segment elevation myocardial infarction","volume":"1","author":"Ferrari","year":"2016","journal-title":"Arch. Med. Sci. Atheroscler. Dis."},{"key":"ref_34","first-page":"1049","article-title":"The association between white blood cell count and acute myocardial infarction in-hospital mortality: Findings from the National Registry of Myocardial Infarction","volume":"11","author":"Grzybowski","year":"2004","journal-title":"Acad. Emerg. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.ijcard.2006.03.061","article-title":"White blood cell count adds prognostic information to the thrombolysis in myocardial infarction risk index","volume":"116","author":"Kruk","year":"2007","journal-title":"Int. J. Cardiol."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/12\/5736\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:52:22Z","timestamp":1760032342000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/12\/5736"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,15]]},"references-count":35,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["ijms26125736"],"URL":"https:\/\/doi.org\/10.3390\/ijms26125736","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,15]]}}}