Background: Cardiovascular diseases (CVD) are influenced by various established risk factors, including the ratio of neutrophils to lymphocytes and platelets, which has been shown to be an independent risk factor for acute coronary syndrome (ACS). This study aims to create a new scoring system called TANGENTS that utilizes discrete parameters of risk factors and diagnostic parameters to analyze the outcome of coronary artery disease (CAD) patients with comorbidities, particularly Type 2 diabetes mellitus (T2DM).

Methods: We included 151 subjects (mean age 57.92 ± 23.86) who presented with ST-elevation and ST-depression on admission and were treated with heparin, clopidogrel, aspirin, and atorvastatin while undergoing all the necessary diagnostic tests. We obtained ECG and complete blood picture (CBP) results on admission, day 3, and day of discharge.

Results: ST-depression on ECG on day-1 was 0.35 and decreased to 0.30 on the day of discharge. ST-elevation on ECG on day-1 was -0.89 and decreased to -0.16 on the day of discharge. The average neutrophil-to-lymphocyte ratio (NPR) was 0.49, which was high in 144 patients. The mean NLR value was 5.52, indicating a correlation between high NLR values and the magnitude of current injury on admission.

Conclusion: The TANGENTS scoring system can be used as an early evaluation tool for CAD patients with comorbidities to manage and prevent further complications. It allows for progressive differentiation in the severity of clinical outcomes using all the parameters of the score, and the parameters creating the TANGENTS score scale were found to be reliable.

Keywords: TANGENTS Score; ECG (ST-Elevation And ST-Depression); Troponin-I, Stress Scoring Scale; Morisky Adherence Scale