Diagnostic validity of hematologic parameters in evaluation of massive pulmonary embolism

Ateş, Hale; Ateş, İhsan; Kundi, Harun; Yılmaz, Fatma Meriç

doi:10.1002/jcla.22072

Cited by 24 publications

(30 citation statements)

References 20 publications

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“…simplified PESI). 23,26 Similarly, in this study, PLR was correlated with the simplified PESI, whilst the other two indices lacked such correlation. However, the PLR levels were not different between patient with and without adverse events and it only had a fair predictive performance in predicting in-hospital mortality.…”

Section: Discussionsupporting

confidence: 54%

“…15,21,22 Nevertheless, these studies were not consistent so far and some studies failed to find a correlation between MPV and disease severity. 21,23 In this study, the simplified PESI outperformed the platelet indices in prognosticating patients with acute PTE. Akgülü et al in a study showed that the predictive performance of extensively-studied risk scores such as the simplified PESI can be improved by addition of factors such as MPV.…”

Section: Discussionmentioning

confidence: 70%

See 1 more Smart Citation

Prognostic value of platelet indices in patients with acute pulmonary thromboembolism

Ghaffari

Parvizian

Pourafkari

et al. 2020

J Cardiovasc Thorac Res

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Introduction: Given the role of platelets in thrombus formation, markers of platelet activation may be able to predict outcomes in patients with acute pulmonary thromboembolism (PTE). Methods: In a prospective cohort study, 492 patients with acute PTE were enrolled. Patients were evaluated for platelet indices including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-lymphocyte-ratio (PLR), as well as for the simplified Pulmonary Embolism Severity Index (PESI) risk score. The primary endpoint was in-hospital all-cause mortality. Major adverse cardiopulmonary events (MACPE, composite of mortality, thrombolysis, mechanical ventilation and surgical embolectomy during index hospitalization) and all-cause death during follow-up were secondary endpoints. Results: MPV, PDW and PLR were 9.9±1.0 fl, 13.5±6.1%, and 14.7±14.5, respectively, in the total cohort. Whilst MPV was higher in those with adverse events (10.1±1.0 vs 9.9±1.0 fl; P = 0.019), PDW and PLR were not different between two groups. MPV with a cut-off point of 9.85 fl had a sensitivity of 81% and a specificity of 50% in predicting in-hospital mortality, but it had lower performance in predicting MACPE (Area under the curve: AUC 0.58; 95%CI 0.52-0.63) or long-term mortality (AUC 0.54; 95% CI 0.47-0.61). The AUC for all these three markers were lower than the AUC calculated for the simplified PESI score (0.80; 0.71-0.88). Conclusion: Platelet indices had only fair-to-good predictive performance in predicting in-hospital all-cause death. Established PTE risk scoring models such as simplified PESI outperform these indices in predicting adverse outcomes. Article info TUOMS P R E S SPlatelets indicies in acute pulmonary thromboembolism

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 70%

Prognostic value of platelet indices in patients with acute pulmonary thromboembolism

Ghaffari

Parvizian

Pourafkari

et al. 2020

J Cardiovasc Thorac Res

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“…21 The variations observed may be due to differences between study populations with ours having substantially less patients with massive PE compared to the cohort studied by Ates et al (n ¼ 13 vs n ¼ 218). 21 Furthermore, our exclusion criteria did not encompass conditions such as heart failure, RV and LV dysfunction, intracardiac thrombus, pericardial effusion, nephrotic syndrome, acute renal and liver failure, endocrine disorders, major surgical interventions, major trauma, and intubation. 21 Future studies in acute PE should consider the prognostic utility of serial NLR and PLR measurements since inflammation is a dynamic process.…”

Section: Discussionmentioning

confidence: 64%

“…In contrast, Ates et al found that PLR was significantly elevated in patients with massive PE compared to patients with submassive or low-risk PE. 21 It is worth noting that other studies have observed an elevation of PLR in patients with RV dysfunction and a positive correlation between PLR and RV/LV ratio. 19,22 In fact, PLR has also been positively correlated with CT pulmonary artery obstruction index, suggesting that higher PLR is associated with increased thrombus burden.…”

Section: Discussionmentioning

confidence: 77%

Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios Predict All-Cause Mortality in Acute Pulmonary Embolism

Phan

Brailovsky

Fareed

et al. 2020

Clin Appl Thromb Hemost

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The aim of this study was to investigate the utility of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to predict all-cause mortality in patients presenting with acute pulmonary embolism (PE). Three hundred consecutive patients with acute PE between March 2016 and December 2018 were retrospectively analyzed. We identified 191 patients who met the study inclusion criteria. Twenty-eight patients died during the study period. There was a significant difference in PLR, but not NLR, between patients with low risk, submassive, and massive risk PE ( P = .02 and P = .58, respectively, by the Kruskal-Wallis test). Elevated NLR and PLR were associated with all-cause mortality ( P < .01 and P < .01, respectively). Neutrophil-to-lymphocyte ratio of 5.46 was associated with all-cause mortality with sensitivity of 75.0% and specificity of 66.9% (area under the curve [AUC]: 0.692 [95% confidence interval, CI]: 0.568-0.816); P < .01). Platelet-to-lymphocyte ratio of 256.6 was associated with all-cause mortality with sensitivity of 53.6% and specificity of 82.2% (AUC: 0.693 [95% CI: 0.580-0.805]; P < .01). Neutrophil-to-lymphocyte ratio and PLR are simple biomarkers that are readily available from routine laboratory values and may be useful components of PE risk prediction models.

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“…While this high value increased along the severity of the disease, there was no difference observed between patients with thrombosis development and those without 27 . Similarly, studies on pulmonary embolism patients showed a linear relationship between PLR values and the severity of the disease, and found it closely related to mortality [28][29][30] . In addition to these, in the study by Yang et al on cancer patients, PLR values over 260 were found to be an independent risk factor for development of venous thrombosis 22 .…”

Section: Discussionmentioning

confidence: 89%

The role of mean platelet volume, platelet distribution width and platelet / lymphocyte ratio in development of cerebral venous thrombosis

Bolayir¹,

Gökçe²

2017

Cumhuriyet Medical Journal

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SUMMARYObjective: Mean platelet volume (MPV) and platelet distribution width (PDW) are parameters that indicate platelet volume. It is assumed that large platelets are enzymatically and metabolically more active than small platelets. The relationship between elevated MPV and PDW values and arterial thrombosis has been demonstrated, but their roles in venous thrombosis are not fully understood. While the platelet / lymphocyte ratio (PLR), which is considered to be an inflammatory indicator, is known to be associated with many diseases, there are only a few studies in venous thrombosis. For this reason, our aim in this study is to establish the relationship between MPV, PDW and PLR values and cerebral venous sinus thrombosis (CVST). Method: Our study included 54 patients who were diagnosed with CVST in our clinic between January 2008 and September 2016, and 50 controls with similar age and sex. The patients and control groups were compared in terms of MPV, PDW and PLR values. In addition, the patient group was divided into two groups, according to parenchymal brain lesions, and the effect of MPV, PDW, and PLR on prognosis was also assessed. Results: While the MPV, PDW and PLR values were higher in the patient group compared to the controls, there was no significant difference between patients with and without parenchymal lesions. In addition, as MPV and PDW values for CVST development were determined as significant independent variables, optimal cut-off values were identified 8.85 for MPV, 15.75 for PDW and 168.53 for PLR in ROC analysis. Conclusions: As a result, MPV, PDW and PLR values were higher in patients with SVST than controls, however their prognostic significance was not determined. In addition, we may suggest that higher MPV and PDW values are new independent risk factors for CVST development. Keywords: Mean platelet volüme, Platelet distribution width, platelet / lymphocyte ratio, cerebral venous thrombosis ÖZET Amaç: Ortalama platelet hacmi (OPH) ve platelet dağılım genişliği (PDG), platelet hacmini gösteren parametrelerdir. Büyük plateletlerin küçük plateletlere kıyasla enzimatik ve metabolik olarak daha aktif kabul edilmektedir. Artmış OPH ve PDG değerleri ile arteryel tromboz arasındaki ilişki gösterilmiştir ancak venöz trombozdaki yeri tam olarak bilinmemektedir. İnflamatuar bir gösterge kabul edilen platelet/ lenfosit oranının artışının(PLO) birçok hastalıkla ilişkisi bilinmekteyken venöz trombozda kullanımı ile ilgili az sayıda çalışma mevcuttur. Bu nedenle bu çalışmamızdaki amacımız OPH, PDG ve PLO değerleri ile serebral venöz sinüs trombozu(SVST) arasındaki ilişkiyi ortaya koymaktır. Yöntem: Çalışmamıza retrospektif olarak Ocak 2008-Eylül 2016 tarihleri arasında kliniğimizde SVST tanısı ile izlenmiş 54 hasta ile benzer yaş ve cinsiyete sahip 50 kontrol dahil edildi. Hasta ve kontrol grubu OPH, PDG ve PLO değerleri açısından kıyaslandı. Bunun yanında hasta grubu kendi içinde beyin parankimal lezyonu olan ve olmayanlar olarak ikiye ayrılarak OPH, PDG ve PLO'nun prognoz üzerindeki etkisi de değer...

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Diagnostic validity of hematologic parameters in evaluation of massive pulmonary embolism

Abstract: We determined that the levels of NLR and PLR are superior to other parameters in the determination of clinical severity in APE cases.

Cited by 24 publications

References 20 publications

Prognostic value of platelet indices in patients with acute pulmonary thromboembolism

Prognostic value of platelet indices in patients with acute pulmonary thromboembolism

Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios Predict All-Cause Mortality in Acute Pulmonary Embolism

The role of mean platelet volume, platelet distribution width and platelet / lymphocyte ratio in development of cerebral venous thrombosis

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