Combined Usefulness of the Platelet-to-Lymphocyte Ratio and the Neutrophil-to-Lymphocyte Ratio in Predicting the Long-Term Adverse Events in Patients Who Have Undergone Percutaneous Coronary Intervention with a Drug-Eluting Stent

Abstract

ObjectivesThe aim of this study was to investigate the combined usefulness of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in predicting the long-term adverse events in patients who have undergone percutaneous coronary intervention (PCI) with a drug-eluting stent (DES).Methods798 patients with stable angina, unstable angina and non-ST elevated myocardial infarction (NSTEMI) who underwent elective successful PCI with DES were consecutively enrolled. The value of PLR and NLR in predicting adverse coronary artery disease (CAD) events and the correlations between these markers and adverse events (all-cause mortality, cardiac death, and nonfatal myocardial infarction) were analyzed.ResultsThe follow-up period was 62.8 ± 28.8 months. When patients were classified into four groups according to the optimal cut-off values for the PLR and NLR on receiver operating characteristic analysis, patients with a high PLR (>128) and high NLR (>2.6) had the highest occurrence of adverse events among the groups. On Cox multivariate analysis, the NLR >2.6 [hazard ratio (HR) 2.352, 95% confidence interval (CI) 1.286 to 4.339, p = 0.006] and the PLR >128 (HR 2.372, 95% CI 1.305 to 3.191, p = 0.005) were independent predictors of long-term adverse events after adjusting for cardiovascular risk factors. Moreover, both a PLR >128 and a NLR >2.6 were the strongest predictors of adverse events (HR 2.686, 95% CI 1.452 to 4.970, p = 0.002).ConclusionHigh pre-intervention PLR and NLR, especially when combined, are independent predictors of long-term adverse clinical outcomes such as all-cause mortality, cardiac death, and myocardial infarction in patients with unstable angina and NSTEMI who have undergone successful PCI with DES.

Mean platelet volume-to-lymphocyte ratio: a novel marker of poor short- and long-term prognosis in patients with diabetes mellitus and acute myocardial infarction

“…Thus far, many authors reported a high admission PLR to be a significant predictor short-and long-term mortality in patients with acute coronary syndromes (Cho, Ann, Singh, Her, & Shin, 2015;Cicek et al, 2015;Hudzik et al, 2015;Ozcan Cetin et al, 2016;Toprak et al, 2015). Ozcan Cetin et al examined PLR prognostic value on in-hospital and long-term MACE (stent thrombosis, nonfatal myocardial infarction, and mortality) in patients with STEMI.…”

Hematological predictors and clinical outcomes in cardiac surgery

“…For descriptive statistics, continuous variables were presented as mean ± standard deviation (SD), and nominal variables were presented as the number of patients (n) and percentage [5]. In univariate analysis and cross-tables, chisquare and Fisher's exact chi-square tests were used.…”

“…Because the normal range for RDW is considered to be 11.5-15.6, the cutoff value was set as >15.6. The high threshold for MPV was set as 8.75 [4], and the cutoff values for PLR and NLR were set as 128 [5] and 2.81 [6], respectively.…”

Relationship between CRP, systemic immune-inflammation index and routine hemogram related inflammatory markers in low grade inflammation

“…The neutrophil-to-lymphocyte ratio (NLR) and the platelet-tolymphocyte ratio (PLR) parameters have been reported to be cost-effective measures of many systemic inflammatory processes [3,4,13,14]. Moreover, Lappé et al [15] demonstrated that the red cell distribution width (RDW), which measures the variation in red blood cell size, is associated with chronic inflammation.…”