Platelet to lymphocyte ratio as a prognostic marker in primary percutaneous coronary intervention
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Abstract
We investigated the predictive significance of the platelet-to-lymphocyte ratio (PLR) in patients undergoing primary percutaneous coronary intervention (pPCI) for acute myocardial infarction (AMI). The study included 440 patients who underwent pPCI and were categorized into two groups based on their PLR levels: low PLR (<137) and high PLR (≥137). Thrombolysis In Myocardial Infarction (TIMI) flow grades and Syntax scores (SXS) were computed from initial angiograms. Data on in-hospital mortality rates and cardiac adverse events were collected from medical records. Patients with high PLR exhibited more instances of no-reflow, higher SXS values, and elevated mortality rates (p < 0.001, p < 0.001, and p = 0.008, respectively). Receiver operating characteristic curve analysis revealed that high PLR predicted the occurrence of no-reflow (specificity 71% and sensitivity 85%), SXS ≥ 22 (specificity 52% and sensitivity 61%), and adverse events during hospitalization (specificity 67% and sensitivity 63%). Multivariate regression analysis identified PLR as an independent risk factor for no-reflow, SXS ≥ 22, and in-hospital adverse events. Additionally, we explored the associations between mean platelet volume, red cell distribution width, neutrophil-to-lymphocyte ratio, and the occurrence of no-reflow, SXS, and in-hospital adverse events.
References
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9. Wang D, Yang JX, Cao DY, Wan XR, Feng FZ, Huang HF, Shen K, Xiang Y. Preoperative neutrophil-lymphocyte and platelet-lymphocyte ratios as independent predictors of cervical stromal involvement in surgically treated endometrioid adenocarcinoma. OncoTargets and Therapy. 2013;6:211–216.
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12. Azab B, Shah N, Akerman M, McGinn Jr JT. Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-ST-elevation myocardial infarction. Journal of Thrombosis and Thrombolysis. 2012;34:326–334.
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15. Liu Q, Wang T, Chen R, Liu C, Yue W, Hong J, Jia R. Mean platelet volume predicts left descending artery occlusion in patients with non-ST-elevation myocardial infarction. Platelets. 2014;25:246–251.
16. Koseoglu HI, Altunkas F, Kanbay A, Doruk S, Etikan I, Demir O. Platelet-lymphocyte ratio is an independent predictor for cardiovascular disease in obstructive sleep apnea syndrome. [Published online July 8, 2014]. Journal of Thrombosis and Thrombolysis. 2014; in press.
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19. Bhat T, Teli S, Rijal J, Bhat H, Raza M, Khoueiry G, Meghani M, Akhtar M, Costantino T. Neutrophil to lymphocyte ratio and cardiovascular diseases: A review. Expert Review of Cardiovascular Therapy. 2013;11:55–59.
20. Murat SN, Duran M, Kalay N, Gunebakmaz O, Akpek M, Doger C, Elcik D, Ocak A, Vatankulu MA, Turfan M, et al. Relation between mean platelet volume and severity of atherosclerosis in patients with acute coronary syndromes. Angiology. 2013;64:131–136.
21. Akin F, Kose N, Ayca B, Katkat F, Duran M, Uysal OK, Arinc H. Relation between red cell distribution width and severity of coronary artery disease in patients with acute myocardial infarction. Angiology. 2013;64:592–596.
22. Azab B, Torbey E, Singh J, Akerman M, Khoueiry G, McGinn JT, Widmann WD, Lafferty J. Mean platelet volume/platelet count ratio as a predictor of long-term mortality after non-ST-elevation myocardial infarction. Platelets. 2011;22:557–566.
23. Akin F, Ayca B, Kose N, Sahin I, Akin MN, Canbek TD, Gungor O. Effect of atorvastatin on hematologic parameters in patients with hypercholesterolemia. Angiology. 2013;64:621–625.
24. Lindemann S, Kraemer B, Seizer P, Gawaz M. Platelets, inflammation and atherosclerosis. Journal of Thrombosis and Haemostasis. 2007;5:203–211.
25. Tantry US, Bliden KP, Suarez TA, Kreutz RP, Dichiara J, Gurbel PA. Hypercoagulability, platelet function, inflammation and coronary artery disease acuity: Results of the Thrombotic RIsk Progression (TRIP) Study. Platelets. 2010;21:360–367.
26. Gurbel PA, Bliden KP, Kreutz RP, Dichiara J, Antonino MJ, Tantry US. The link between heightened thrombogenicity and inflammation: Pre-procedure characterization of the patient at high risk for recurrent events after stenting. Platelets. 2009;20:97–104.
27. Iyú D, Glenn JR, White AE, Johnson AJ, Fox SC, Heptinstall S. The role of prostanoid receptors in mediating the effects of PGE(2) on human platelet function. Platelets. 2010;21:329–342.
28. Verdoia M, Secco GG, Barbieri L, Cassetti E, Schaffer A, Sinigaglia F, Marino P, Suryapranata H, De Luca G; Novara Atherosclerosis Study Group (NAS). Platelet HPA-1 a/HPA-1 b polymorphism and the risk of periprocedural myocardial infarction in patients undergoing elective PCI. Platelets. 2014;25:367–372.
2. Falk E. Pathogenesis of atherosclerosis. Journal of the American College of Cardiology. 2006;47:7–12.
3. Fuentes QE, Fuentes QF, Andrés V, Pello OM, Font de Mora J, Palomo GI. Role of platelets as mediators that link inflammation and thrombosis in atherosclerosis. Platelets. 2013;24:255–262.
4. Klovaite J, Benn M, Yazdanyar S, Nordestgaard BG. High platelet volume and increased risk of myocardial infarction: 39,531 participants from the general population. Journal of Thrombosis and Haemostasis. 2011;9:49–56.
5. Gibson CM, Kirtane AJ, Morrow DA, Palabrica TM, Murphy SA, Stone PH, Scirica BM, Jennings LK, Herrmann HC, Cohen DJ, et al; TIMI Study Group. Association of platelet counts on presentation and clinical outcomes in ST-elevation myocardial infarction (from the TIMI Trials). American Journal of Cardiology. 2006;98:1–5.
6. Ommen SR, Gibbons RJ, Hodge DO, Thomson SP. Usefulness of the lymphocyte concentration as a prognostic marker in coronary artery disease. American Journal of Cardiology. 1997;79:812–814.
7. Bian C, Wu Y, Shi Y, Xu G, Wang J, Xiang M, Weng S, Jiang J, Ma J. Predictive value of the relative lymphocyte count in coronary heart disease. Heart and Vessels. 2010;25:469–473.
8. Smith RA, Ghaneh P, Sutton R, Raraty M, Campbell F, Neoptolemos JP. Prognosis of resected ampullary adenocarcinoma by preoperative serum CA19-9 levels and platelet-lymphocyte ratio. Journal of Gastrointestinal Surgery. 2008;12:1422–1428.
9. Wang D, Yang JX, Cao DY, Wan XR, Feng FZ, Huang HF, Shen K, Xiang Y. Preoperative neutrophil-lymphocyte and platelet-lymphocyte ratios as independent predictors of cervical stromal involvement in surgically treated endometrioid adenocarcinoma. OncoTargets and Therapy. 2013;6:211–216.
10. Templeton AJ, Ace O, McNamara MG, Al-Mubarak M, Vera-Badillo FE, Hermanns T, Seruga B, Ocana A, Tannock IF, Amir E. Prognostic role of platelet to lymphocyte ratio in solid tumors: A systematic review and meta-analysis. Cancer Epidemiology Biomarkers and Prevention. 2014;23:1204–1212.
11. Krenn-Pilko S, Langsenlehner U, Thurner EM, Stojakovic T, Pichler M, Gerger A, Kapp KS, Langsenlehner T. The elevated preoperative platelet-to-lymphocyte ratio predicts poor prognosis in breast cancer patients. British Journal of Cancer. 2014;110:2524–2530.
12. Azab B, Shah N, Akerman M, McGinn Jr JT. Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-ST-elevation myocardial infarction. Journal of Thrombosis and Thrombolysis. 2012;34:326–334.
13. Yildiz A, Yuksel M, Oylumlu M, Polat N, Akyuz A, Acet H, Aydin M, Ulgen MS. The utility of the platelet–lymphocyte ratio for predicting no reflow in patients with ST-segment elevation myocardial infarction. [Published online January 14, 2014].
14. Temiz A, Gazi E, Gungor O, Barutcu A, Altun B, Bekler A, Binnetoglu E, Sen H, Gunes F, Gazi S. Platelet/lymphocyte ratio and risk in-hospital mortality in patients with ST-elevated myocardial infarction. Medical Science Monitor. 2014;22:660–665.
15. Liu Q, Wang T, Chen R, Liu C, Yue W, Hong J, Jia R. Mean platelet volume predicts left descending artery occlusion in patients with non-ST-elevation myocardial infarction. Platelets. 2014;25:246–251.
16. Koseoglu HI, Altunkas F, Kanbay A, Doruk S, Etikan I, Demir O. Platelet-lymphocyte ratio is an independent predictor for cardiovascular disease in obstructive sleep apnea syndrome. [Published online July 8, 2014]. Journal of Thrombosis and Thrombolysis. 2014; in press.
17. Choi SW, Choi DH, Kim HW, Ku YH, Ha SI, Park G. Clinical outcome prediction from mean platelet volume in patients undergoing percutaneous coronary intervention in Korean cohort: Implications of more simple and useful test than platelet function testing. Platelets. 2014;25:322–327.
18. Kurtul A, Murat SN, Yarlioglues M, Duran M, Karadeniz M, Ergun G, Akyel A, Mendi MA, Oksuz F. The association of red cell distribution width with in-stent restenosis in patients with stable coronary artery disease. [Published online, May 4, 2014]. Platelets. 2014; in press.
19. Bhat T, Teli S, Rijal J, Bhat H, Raza M, Khoueiry G, Meghani M, Akhtar M, Costantino T. Neutrophil to lymphocyte ratio and cardiovascular diseases: A review. Expert Review of Cardiovascular Therapy. 2013;11:55–59.
20. Murat SN, Duran M, Kalay N, Gunebakmaz O, Akpek M, Doger C, Elcik D, Ocak A, Vatankulu MA, Turfan M, et al. Relation between mean platelet volume and severity of atherosclerosis in patients with acute coronary syndromes. Angiology. 2013;64:131–136.
21. Akin F, Kose N, Ayca B, Katkat F, Duran M, Uysal OK, Arinc H. Relation between red cell distribution width and severity of coronary artery disease in patients with acute myocardial infarction. Angiology. 2013;64:592–596.
22. Azab B, Torbey E, Singh J, Akerman M, Khoueiry G, McGinn JT, Widmann WD, Lafferty J. Mean platelet volume/platelet count ratio as a predictor of long-term mortality after non-ST-elevation myocardial infarction. Platelets. 2011;22:557–566.
23. Akin F, Ayca B, Kose N, Sahin I, Akin MN, Canbek TD, Gungor O. Effect of atorvastatin on hematologic parameters in patients with hypercholesterolemia. Angiology. 2013;64:621–625.
24. Lindemann S, Kraemer B, Seizer P, Gawaz M. Platelets, inflammation and atherosclerosis. Journal of Thrombosis and Haemostasis. 2007;5:203–211.
25. Tantry US, Bliden KP, Suarez TA, Kreutz RP, Dichiara J, Gurbel PA. Hypercoagulability, platelet function, inflammation and coronary artery disease acuity: Results of the Thrombotic RIsk Progression (TRIP) Study. Platelets. 2010;21:360–367.
26. Gurbel PA, Bliden KP, Kreutz RP, Dichiara J, Antonino MJ, Tantry US. The link between heightened thrombogenicity and inflammation: Pre-procedure characterization of the patient at high risk for recurrent events after stenting. Platelets. 2009;20:97–104.
27. Iyú D, Glenn JR, White AE, Johnson AJ, Fox SC, Heptinstall S. The role of prostanoid receptors in mediating the effects of PGE(2) on human platelet function. Platelets. 2010;21:329–342.
28. Verdoia M, Secco GG, Barbieri L, Cassetti E, Schaffer A, Sinigaglia F, Marino P, Suryapranata H, De Luca G; Novara Atherosclerosis Study Group (NAS). Platelet HPA-1 a/HPA-1 b polymorphism and the risk of periprocedural myocardial infarction in patients undergoing elective PCI. Platelets. 2014;25:367–372.
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May 20, 2022
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Abdulaziz Khaleef J Alanazi, Yusif Eid Awad Al-Rashidi, Abdulmajeed Mutayliq K Aljameeli, Omar Jaber Mathan Alruwaili, Mtaib Obaid S Alanazi, Fahad Obaid S Alanazi. (2022). Platelet to lymphocyte ratio as a prognostic marker in primary percutaneous coronary intervention. Journal of Population Therapeutics and Clinical Pharmacology, 29(04), 1161-1166. https://doi.org/10.53555/jptcp.v29i04.5705
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All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Abdulaziz Khaleef J Alanazi, Yusif Eid Awad Al-Rashidi, Abdulmajeed Mutayliq K Aljameeli, Omar Jaber Mathan Alruwaili, Mtaib Obaid S Alanazi, Fahad Obaid S Alanazi. (2022). Platelet to lymphocyte ratio as a prognostic marker in primary percutaneous coronary intervention. Journal of Population Therapeutics and Clinical Pharmacology, 29(04), 1161-1166. https://doi.org/10.53555/jptcp.v29i04.5705