Platelet/lymphocyte ratio and risk of in-hospital mortality in patients with ST-elevated myocardial infarction

Ahmet Temiz, Emine Gazi, Ömer Güngör, Ahmet Barutçu, Burak Altun, Adem Bekler, Emine Binnetoğlu, Hacer Şen, Fahri Güneş, Sabri Gazi, Ahmet Temiz, Emine Gazi, Ömer Güngör, Ahmet Barutçu, Burak Altun, Adem Bekler, Emine Binnetoğlu, Hacer Şen, Fahri Güneş, Sabri Gazi

Abstract

Background: Platelet-to-lymphocyte ratio (PLR) is a new prognostic marker in coronary artery disease. We aimed to evaluate the relationship between PLR and in-hospital mortality in patients with ST-elevated acute myocardial infarction (AMI).

Material and methods: The present study included 636 patients with ST-elevated AMI. The study population was divided into tertiles based on their admission PLR. Patients having values in the third tertile was defined as the high PLR group (n=212) and those having values in the lower 2 tertiles were defined as the low PLR group (n=424).

Results: Risk factors of coronary artery disease and treatments administered during the in-hospital period were similar between the groups. Male patient ratio was found to be lower in the high PLR group (73% vs. 82.8%, p=0.004). In-hospital mortality was increased in the high PLR group when compared to the low PLR group (12.7% vs. 5.9%, p=0.004). The PLR >144 was found to be an independent predictor of in-hospital cardiovascular mortality (HR: 2.16, 95% CI: 1.16-4.0, p=0.014).

Conclusions: This study showed that PLR is an independent predictor of cardiovascular mortality in patients with ST-elevated AMI.

Figures

Figure 1
Figure 1
ROC curve for the platelet/lymphocyte ratio.

References

    1. Davies MJ, Thomas AC. Plaque fissuring: the cause of acute myocardial infarction, sudden ischaemic death, and crescendo angina. Br Heart J. 1985;53:363–73.
    1. Fauci AS, Braundwald E, Kasper DL, et al. Harrison’s principle of internal medicine. 17th ed. 2008. McGraw-Hill: chapter of disorders of the cardiovascular system (Part 9) pp. 1514–16.
    1. Falk E. Pathogenesis of atherosclerosis. J Am Coll Cardiol. 2006;47:7–12.
    1. Davi G, Patrono C. Platelet activation and atherothrombosis. N Engl J Med. 2007;357:2482–94.
    1. Klovaite J, Benn M, Yazdanyar S, Nordestgaard BG. High platelet volume and increased risk of myocardial infarction: 39,531 participants from the general population. J Thromb Haemost. 2011;9:49–56.
    1. Ly HQ, Kirtane AJ, Murphy SA, et al. Association of platelet counts on presentation and clinical outcomes in ST-elevation myocardial infarction (from the TIMI Trials) Am J Cardiol. 2006;98:1–5.
    1. Kilicli-Camur N, Demirtunç R, Konuralp C, et al. Could mean platelet volume be a predictive marker for acute myocardial infarction? Med Sci Monit. 2005;11(8):CR387–92.
    1. Glud T, Schmidt EB, Kristensen SD, Arnfred T. Platelet number and volume during myocardial infarction in relation to infarct size. Acta Med Scand. 1986;220:401–5.
    1. Horne BD, Anderson JL, John JM, et al. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol. 2005;45:1638–43.
    1. Frangogiannis NG, Smith CW, Entman ML. The inflammatory response in myocardial infarction. Cardiovasc Res. 2002;53:31–47.
    1. Azab B, Shah N, Akerman M, McGinn JT., Jr Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-ST-elevation myocardial infarction. J Thromb Thrombolysis. 2012;34:326–34.
    1. Levey AS, Bosch JP, Lewis JB, et al. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999;130:461–70.
    1. Libby P, Ridker PM, Maseri A. Inflammation and Atherosclerosis. Circulation. 2002;105(9):1135–43.
    1. Gawaz M, Langer H, May AE. Platelets in inflammation and atherogenesis. J Clin Invest. 2005;115:3378–84.
    1. Lindemann S, Krämer B, Seizer P, Gawaz M. Platelets, inflammation and atherosclerosis. J Thromb Haemost. 2007;5(Suppl 1):203–11.
    1. Libby P. Current concepts of the pathogenesis of the acute coronary syndromes. Circulation. 2001;104:365–72.
    1. Falk E. Pathogenesis of atherosclerosis. J Am Coll Cardiol. 2006;47(8 Suppl):7–12.
    1. Gary T, Pichler M, Belaj K, et al. Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients. PLoS One. 2013;8:676–88.
    1. Healy AM, Pickard MD, Pradhan AD, et al. Platelet expression profiling and clinical validation of myeloid-related protein-14 as a novel determinant of cardiovascular events. Circulation. 2006;113:2278–84.
    1. Ly HQ, Kirtane AJ, Murphy SA, et al. Association of platelet counts on presentation and clinical outcomes in ST-elevation myocardial infarction (from the TIMI Trials) Am J Cardiol. 2006;98:1–5.
    1. Mueller C, Neumann FJ, Hochholzer W, et al. The impact of platelet count on mortality in unstable angina/non-ST-segment elevation myocardial infarction. Am Heart J. 2006;151:1214. e1–7.
    1. Slavka G, Perkmann T, Haslacher H, et al. Mean platelet volume may represent a predictive parameter for overall vascular mortality and ischemic heart disease. Arterioscler Thromb Vasc Biol. 2011;31:1215–18.
    1. Nikolsky E, Grines CL, Cox DA, et al. Impact of baseline platelet count in patients undergoing primary percutaneous coronary intervention in acute myocardial infarction (from the CADILLAC trial) Am J Cardiol. 2007;99:1055–61.
    1. Frangogiannis NG, Smith CW, Entman ML. The inflammatory response in myocardial infarction. Cardiovasc Res. 2002;53:31–47.
    1. Gurwitz JH, Col NF, Avorn J. The exclusion of the elderly and women from clinical trials in acute myocardial infarction. JAMA. 1992;268:1417–22.
    1. Rich MW, Bosner MS, Chung MK, et al. Is age an independent predictor of early and late mortality in patients with acute myocardial infarction? Am J Med. 1992;92:7–13.
    1. Akpek M, Kaya MG, Lam YY, et al. Relation of neutrophil/lymphocyte ratio to coronary flow to in-hospital major cardiac events in patients with ST elevated myocardial infarction undergoing primary coronary intervention. Am J Cardiol. 2012;110(5):621–27.

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