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

Temız, Ahmet; Gazı, Emıne; Güngör, Ömer; Barutçu, Ahmet; Altun, Burak; Bekler, Adem; Binnetoğlu, Emine; Şen, Hacer; Güneş, Fahri; Gazi, Sabri

doi:10.12659/msm.890152

Cited by 76 publications

(35 citation statements)

References 23 publications

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“…Because NLR and CRP can be easily obtained from routine laboratory examination in patients visiting the hospital due to acute chest pain, prediction of the prognosis in AMI patients with these biomarkers might be much easier and more comfortable than other biomarkers. PLR is also known as a good prognostic marker for cardiovascular events 21)22). In a previous study, combined NLR and PLR levels also predicted severity of CAD23) and adverse clinical outcomes 24).…”

Section: Discussionmentioning

confidence: 95%

Combined Use of Neutrophil to Lymphocyte Ratio and C-Reactive Protein Level to Predict Clinical Outcomes in Acute Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention

et al. 2017

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Background and ObjectivesBoth neutrophil to lymphocyte ratio (NLR) and C-reactive protein (CRP) are biomarkers associated with poor prognosis of patients with acute myocardial infarction (AMI). However, the combined usefulness of NLR and CRP in predicting adverse outcomes has not been investigated.Subjects and MethodsWe analyzed 381 consecutive AMI patients who underwent percutaneous coronary intervention (PCI) from January 2012 to January 2014. The endpoints were all-cause mortality, recurrent myocardial infarction (MI), stent thrombosis, repeat revascularization, stroke, and major adverse cardiac and cerebrovascular events (MACCE) at 2-year follow-up. Included patients were divided into 4 groups according to the optimal cut-off values for NLR and CRP on receiver operating characteristic analysis predicting mortality.ResultsPatients with both high NLR (>6.30) and high CRP (>0.76) had significantly greater risk of all-cause death and MACCE at 24 months, with no significant increase in the risk of recurrent MI, stent thrombosis, or stroke compared with patients with either low NLR or low CRP, as well as those with low NLR and low CRP. Kaplan-Meier analysis revealed significantly lower survival in patients with high NLR-CRP. On Cox multivariate analysis, high NLR-CRP (hazard ratio 23.172, 95% confidence interval 6.575 to 81.671, p<0.001) was an independent predictor of all-cause death.ConclusionElevated levels of both NLR and CRP are associated with increased risk of long-term mortality in AMI patients who have undergone PCI.

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Section: Discussionmentioning

confidence: 95%

Combined Use of Neutrophil to Lymphocyte Ratio and C-Reactive Protein Level to Predict Clinical Outcomes in Acute Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention

et al. 2017

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“…After that this marker was found to be associated with inflammation in cardiovascular diseases and positively correlated with SYNTAX score, GRACE risk and no-reflow phenomenon in ACS9202829. Most recently a series of studies have investigated the predictive importance of PLR in the adverse outcomes among ACS and reported inconsistent results9102229. We conducted this meta-analysis to comprehensively understand the prognostic role of PLR in ACS.…”

Section: Discussionmentioning

confidence: 99%

“…Temiz et al . reported that PLR was an independent predictor of in-hospital cardiovascular mortality in patients with ST-elevated acute myocardial infarction9. Ugur et al .…”

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confidence: 99%

Platelet to lymphocyte ratio in the prediction of adverse outcomes after acute coronary syndrome: a meta-analysis

Liu²,

Tang

2017

Sci Rep

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Recent studies have shown platelet to lymphocyte ratio (PLR) to be a potential inflammatory marker in cardiovascular diseases. We performed a meta-analysis to systematically evaluate the prognostic role of PLR in acute coronary syndrome (ACS). A comprehensive literature search up to May 18, 2016 was conducted from PUBMED, EMBASE and Web of science to identify related studies. The risk ratio (RR) with 95% confidence interval (CI) was extracted or calculated for effect estimates. Totally ten studies involving 8932 patients diagnosed with ACS were included in our research. We demonstrated that patients with higher PLR level had significantly higher risk of in-hospital adverse outcomes (RR = 2.24, 95%CI = 1.81–2.77) and long-term adverse outcomes (RR = 2.32, 95%CI = 1.64–3.28). Sensitivity analyses confirmed the stability of our results. We didn’t detect significant publication bias by Begg’s and Egger’s test (p > 0.05). In conclusion, our meta-analysis revealed that PLR is promising biomarker in predicting worse prognosis in ACS patients. The results should be validated by future large-scale, standard investigations.

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“…Recently, PLR was found to be a new predictor of some cardiovascular diseases (25, 26). Thus, we evaluated PLR in our present study.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-to-lymphocyte ratio predicts hemodynamic significance of coronary artery stenosis

Akyel¹,

Yayla²,

Erat³

et al. 2015

Anatol J Cardiol

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Objective:Coronary artery disease is closely linked with inflammation, and the neutrophil-to-lymphocyte ratio (NLR) has emerged as a new inflammatory marker. Fractional flow reserve (FFR) is a well-established method for determining hemodynamic significance of coronary artery stenosis. In this study, we aimed to investigate the relationship between NLR and hemodynamic significance of coronary artery lesion as assessed by FFR.Methods:A total of 134 patients with FFR measurement between January 2012 and December 2013 were enrolled in this retrospective study. Patients with single intermediate-grade coronary artery stenosis were enrolled, and those with second intermediate or severe coronary artery stenosis were excluded from study. Patients’ NLR were calculated. An FFR value of <0.80 was accepted for hemodynamic significance. Statistical analysis was performed by the chi-square test, Student’s t-test, Mann–Whitney U test, logistic regression analysis, and ROC curve analysis.Results:Patients with hemodynamically significant lesions had higher NLR values (3.3±1.2 vs. 2.0±0.9, p<0.001). White blood cell count, male gender, high-density lipoprotein levels, platelet-to-lymphocyte ratio, and NLR were found to be possible confounding factors predicting hemodynamically significant coronary artery stenosis. In multiple logistic regression analysis, NLR remained as the only independent predictor for hemodynamically significant coronary artery stenosis. An NLR value of 2.4 had 87.5% sensitivity and 78.4% specificity for prediction of hemodynamically significant coronary artery stenosis.Conclusion:In present study, we showed that NLR was significantly higher in patients with hemodynamically significant coronary artery stenosis. We also found NLR to be an independent predictor of hemodynamically significant coronary artery stenosis as measured by FFR. Further studies are needed to find a causal relationship.

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

Cited by 76 publications

References 23 publications

Combined Use of Neutrophil to Lymphocyte Ratio and C-Reactive Protein Level to Predict Clinical Outcomes in Acute Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention

Combined Use of Neutrophil to Lymphocyte Ratio and C-Reactive Protein Level to Predict Clinical Outcomes in Acute Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention

Platelet to lymphocyte ratio in the prediction of adverse outcomes after acute coronary syndrome: a meta-analysis

Neutrophil-to-lymphocyte ratio predicts hemodynamic significance of coronary artery stenosis

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