Neutrophil to platelet ratio: A novel prognostic biomarker in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention

Somaschini, Alberto; Cornara, Stefano; Demarchi, Andrea; Mandurino-Mirizzi, Alessandro; Fortuni, Federico; Ferlini, Marco; Camporotondo, Rita; Gnecchi, Massimiliano; Visconti, Luigi Oltrona; Ferrari, Gaetano Maria De

doi:10.1177/2047487319894103

Cited by 24 publications

(21 citation statements)

References 10 publications

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“…The PNR, which has also been investigated by several researchers in an inverse manner (NPR), has been described as a marker of systemic inflammation. As such, it has been suggested as a prognostic factor for ischemic stroke, myocardial infarction, thromboangiitis obliterans, infective endocarditis, and other conditions [42][43][44][45]. However, this marker has not yet been investigated in dermatological disorders.…”

Section: Discussionmentioning

confidence: 99%

Hematological Inflammatory Markers in Patients with Pemphigus Vulgaris

et al. 2021

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Background: Emerging evidence indicates that several hematological markers can be used to evaluate treatment response, prediction, and early relapse detection in different inflammatory conditions. This study aimed to investigate the correlation between the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, platelet-to-neutrophil ratio, mean platelet volume, and disease activity in patients with pemphigus vulgaris. Methods: Fifty-six patients (20 men, 36 women; mean age 54 ± 14 years) diagnosed with pemphigus vulgaris were included in this retrospective study. Patients were divided into those treated and not treated with rituximab (groups 1 and 2), and into those who did and did not develop relapse (groups 3 and 4). The neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, platelet-to-neutrophil ratio and mean platelet volume were evaluated at the time of diagnosis, remission, and relapse. The relationship between each marker and disease stage was analyzed using the Wilcoxon rank-sum test for pairwise comparisons. Results: The neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio showed a positive correlation with disease activity, while the platelet-to-neutrophil ratio and mean platelet volume showed a negative correlation. The neutrophil-to-lymphocyte ratio significantly decreased in remission (p < 0.001) and significantly increased in relapse (p < 0.01). The platelet-to-lymphocyte ratio significantly decreased in remission (p < 0.001) and showed no significant change in relapse. The platelet-to-neutrophil ratio significantly increased in remission (p < 0.001) and significantly decreased at relapse (p < 0.001). The mean platelet volume significantly increased in remission (p < 0.001) and decreased non-significantly at relapse. A more significant decrease in the neutrophil-to-lymphocyte ratio in remission was found in patients not treated with rituximab. No significant differences were observed between patients who developed relapse and those who did not. Conclusion: Our results suggest that the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, platelet-to-neutrophil ratio, and mean platelet volume can be useful markers for monitoring treatment response, while the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio can also assist in detecting early relapse.

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Section: Discussionmentioning

confidence: 99%

Hematological Inflammatory Markers in Patients with Pemphigus Vulgaris

et al. 2021

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“…Indeed, the activation of in ammatory mediators and pathways is vastly described as a cornerstone of atherosclerosis 24 , not only in terms of chronic arterial remodelling but also favouring plaque instability and rupture 25 . Moreover, some studies have identi ed an association of elevated in ammatory markers, including NPR and NLR, with larger infarct sizes and an increased risk of short-term mortality 12,26,27 .…”

Section: Discussionmentioning

confidence: 99%

“…Lastly, in our study we did not evaluate other in ammatory markers such as IL-6, TNF-α, IL-1, and the soluble matricellular protein Cysteine-rich angiogenic inducer, which might re ect the in ammatory status more accurately. Taking into account that a correlation between such parameters and the indices adopted in our study was previously demonstrated [11][12][13][14]48,49 , we chose to use common and widely available in ammatory markers for simplicity.…”

Section: Study Limitationsmentioning

confidence: 99%

Hyperglycemia, Inflammatory Response and Infarct Size in Obstructive Acute Myocardial Infarction and MINOCA

Paolisso

Foà

Bergamaschi

et al. 2021

Preprint

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BackgroundHyperglycemia has been associated with increased inflammatory indexes and larger infarct sizes in patients with obstructive acute myocardial infarction (obs-AMI). In contrast, no studies have explored these correlations in non-obstructive acute myocardial infarction (MINOCA). We investigated the relationship between hyperglycemia, inflammation and infarct size in a cohort of AMI patients that included MINOCA.MethodsPatients with AMI undergoing coronary angiography between 2016 and 2020 were enrolled. The following inflammatory markers were evaluated: C-reactive protein, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and neutrophil-to-platelet ratio (NPR). Myocardial infarct size was measured by peak high sensitivity troponin I (Hs-TnI) levels, left-ventricular-end-diastolic-volume (LVEDV) and left ventricular ejection fraction (LVEF).ResultsThe final study population consisted of 2450 patients with obs-AMI and 239 with MINOCA. Hyperglycemia was more prevalent among obs-AMI cases. In all hyperglycemic patients - obs-AMI and MINOCA - NLR, NPR, and LPR were markedly altered. Hyperglycemic obs-AMI subjects exhibited a higher Hs-TnI (p < 0.001), a larger LVEDV (p = 0.003) and a lower LVEF (p < 0.001) compared to normoglycemic ones. Conversely, MINOCA patients showed a trivial myocardial damage, irrespective of admission glucose levels.ConclusionsOur data confirm the association of hyperglycemic obs-AMI with elevated inflammatory markers and larger infarct sizes. MINOCA patients exhibited modest myocardial damage, regardless of admission glucose levels.

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“…The predictive value of the platelet-to-lymphocyte/neutrophil-to-lymphocyte ratio (PLR/NLR) and the systemic immune-inflammation index (platelet count × NLR) were demonstrated to affect the clinical outcomes of STEMI patients [8][9][10][11][12][13]. However, few studies have focused on the [14]. Platelets are inducers and biomarkers of chronic inflammatory conditions such as atherosclerosis and atherothrombosis [15].…”

Section: Introductionmentioning

confidence: 99%

Association between Platelet to Neutrophil Ratio (PNR) and Clinical Outcomes in STEMI Patients after Successful pPCI: A Secondary Analysis Based on a Cohort Study

Wang

Qing

Wang

et al. 2022

Cardiovascular Therapeutics

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Purpose. This study was aimed at investigating whether the platelet-to-neutrophil ratio (PNR) is independently related to the prognosis of patients with ST-elevation myocardial infarction (STEMI) after successful primary percutaneous coronary intervention (pPCI). Methods. This was a secondary analysis of data retrieved from the DATADRYAD database, which was a prospective cohort study. A total of 464 STEMI patients who underwent successful pPCI were recruited between January 2010 and October 2014. The target-independent variable, PNR, was measured at the baseline. The dependent variable in the current study was the occurrence of major adverse cardiovascular events (MACEs) during the 30-month follow-up. Results. Two patients were excluded from the final analysis because their platelet counts were unavailable. The average age of the 462 participants was 63 ± 11.92 years, and approximately 76.6% were male. After adjusting for age, sex, anterior wall myocardial infarction (MI), history of MI, apelin-12, apelin-12 change rate, left ventricular end-diastolic diameter, peak cardiac troponin I, pathological Q wave, Killip classification grade, fasting blood glucose, albumin, GENSINI score, and estimated glomerular filtration rate, a nonlinear relationship was found between the PNR and MACEs in the included cohort. The threshold value of the PNR for MACEs was 23.1. Over this cutoff value, the incidence rate of MACEs increased by 43% per 10-unit change in PNR (95% CI: 1.16–1.75, p = 0.0006 ). Conclusion. There was a threshold relationship between PNR and MACEs in patients with STEMI who underwent successful pPCI. The incidence of MACEs was positively associated with the PNR when the PNR exceeded 23.1.

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Neutrophil to platelet ratio: A novel prognostic biomarker in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention

Cited by 24 publications

References 10 publications

Hematological Inflammatory Markers in Patients with Pemphigus Vulgaris

Hematological Inflammatory Markers in Patients with Pemphigus Vulgaris

Hyperglycemia, Inflammatory Response and Infarct Size in Obstructive Acute Myocardial Infarction and MINOCA

Association between Platelet to Neutrophil Ratio (PNR) and Clinical Outcomes in STEMI Patients after Successful pPCI: A Secondary Analysis Based on a Cohort Study

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