Platelet-to-hemoglobin ratio as a valuable predictor of long-term all-cause mortality in coronary artery disease patients with congestive heart failure

Abstract

Background The platelet-to-hemoglobin ratio (PHR) has emerged as a prognostic biomarker in coronary artery disease (CAD) patients after PCI but not clear in CAD complicated with congestive heart failure (CHF). Hence, we aimed to assess the association between PHR and long-term all-cause mortality among CAD patients with CHF. Methods Based on the registry at Guangdong Provincial People’s Hospital in China, we analyzed data of 2599 hospitalized patients who underwent coronary angiography (CAG) and were diagnosed with CAD complicated by CHF from January 2007 to December 2018. Low PHR was defined as ˂ 1.69 (group 1) and high PHR as ≥ 1.69 (group 2). Prognosis analysis was performed using Kaplan–Meier method. To assess the association between PHR and long-term all-cause mortality, a Cox-regression model was fitted. Results During a median follow-up of 5.2 (3.1–7.8) years, a total of 985 (37.9%) patients died. On the Kaplan–Meier analysis, patients in high PHR group had a worse prognosis than those in low PHR group (log-rank, p = 0.0011). After adjustment for confounders, high PHR was correlated with an increased risk of long-term all-cause mortality in CAD patients complicated with CHF. (adjusted hazard ratio [aHR], 1.31; 95% confidence interval [CI], 1.13–1.52, p < 0.0001). Conclusion Elevated PHR is correlated with an increased risk of long-term all-cause mortality in CAD patients with CHF. These results indicate that PHR may be a useful prognostic biomarker for this population. Meanwhile, it is necessary to take effective preventive measures to regulate both hemoglobin levels and platelet counts in this population.

Platelet, Neutrophil and Lymphocyte Quantitative Abnormalities in Patients with Heart Failure: A Retrospective Study

“…This is because the release of various mediators during the inflammatory response, as well as increased platelet counts in the circulation, cause thrombosis-related complications in patients with congestive heart failure (CHF). 16 Therefore, this study was aimed at determining the magnitude of different leukocyte and platelet count abnormalities and their associated factors among patients with heart failure.…”

Emerging Biomarkers for Predicting Clinical Outcomes in Patients with Heart Disease

“…In ROC analysis, a PLR threshold of 132.6 was shown to have 68.5% specificity and 71.3% sensitivity for the prediction of clinical outcomes (AUC = 0.704, p < 0.001) [ 37 ]. A Chinese retrospective observational cohort on 2599 patients with CAD complicated by congestive heart failure, reported that high platelet to hemoglobin ratio (PHR) was associated with a higher risk of all-cause mortality in unadjusted, age- and gender-adjusted, and fully adjusted models over a median follow-up of 5.2 years [ 38 ]. Patients in the upper quartile of PHR were shown to have an increased risk of all-cause mortality compared to those in the lowest quartile [ 38 ].…”

Platelet-to-Hemoglobin Ratio Is an Important Predictor of In-Hospital Mortality in Patients With ST-Segment Elevation Myocardial Infarction

“…PHR higher than 1.92 is associated with all-cause mortality, cardiac mortality, re-admission, and MACE and/or cerebrovascular events in these patients [ 12 ]. Bao et al showed that a PHR higher than 1.69 was correlated with an increased risk of long-term all-cause mortality in patients with CAD and CHF [ 11 ]. In our study, we found that in-hospital mortality increased more than 2.5 times in patients with a PHR above 1.99.…”

“…The baseline data for all patients included demographic characteristics, medical history, laboratory tests, electrocardiographic, and echocardiographic results. PHR was obtained by the ratio of platelet measured in 10 9 /L and hemoglobin measured in gram/L in the hemogram of admission [ 11 ]. The patients were receiving medical treatment according to current European Society of Cardiology guidelines [ 4 ].…”

“…PHR is a simple hemogram parameter that has been recently used to predict mortality in patients with coronary artery disease (CAD). Elevated PHR was associated with an increased risk of long-term all-cause mortality in patients with CAD and chronic heart failure (CHF) [ 11 ]. PHR is an independent predictor of adverse outcomes in patients with CAD who underwent PCI [ 12 ].…”