2016
DOI: 10.4103/0253-7613.186205
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Platelet-to-lymphocyte ratio but not neutrophil-to-lymphocyte ratio predicts high on-treatment platelet reactivity in clopidogrel-treated patients with acute coronary syndrome

Abstract: Objectives:Dual antiplatelet therapy (DAPT), consisting of clopidogrel and aspirin, is the main-stay treatment of acute coronary syndromes (ACS). However, major adverse cardiovascular events may occur even in patients undergoing DAPT, and this has been related to the variable pharmacodynamic efficacy of these drugs, especially clopidogrel. Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are novel inflammatory markers for cardiovascular risk stratification, which may reflect an infla… Show more

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Cited by 9 publications
(4 citation statements)
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“…In summary, while AUC upper indicates more precise definition of HTPR, NAR rather reflects the inflammatory state in poststroke patients (18). Based on this small, single-center pilot study, these novel markers may provide a better prediction of recurrent ischemic events leading to a better selection of patients at risk and providing an individually tailored vascular therapy including antiplatelet and anti-inflammatory regimens (17,19).…”
Section: Discussionmentioning
confidence: 98%
“…In summary, while AUC upper indicates more precise definition of HTPR, NAR rather reflects the inflammatory state in poststroke patients (18). Based on this small, single-center pilot study, these novel markers may provide a better prediction of recurrent ischemic events leading to a better selection of patients at risk and providing an individually tailored vascular therapy including antiplatelet and anti-inflammatory regimens (17,19).…”
Section: Discussionmentioning
confidence: 98%
“…38,39 This fact might explain the lack of association of PLR with ADP-inducible platelet aggregation in our cohort, contrary to a previous report demonstrating a significant association of PLR with high residual platelet reactivity (defined as change in maximal aggregation ≤20% from baseline aggregation in response to ADP) in patients treated with clopidogrel. 40 However, platelet activation via other surface receptors remains largely unaffected. Thrombin acts as a strong endogenous platelet agonist activating platelets predominantly via PAR-1.…”
Section: Discussionmentioning
confidence: 99%
“…Subsequently it gathered growing interest in patients with coronary artery disease since both platelets and lymphocytes, as mentioned above, are included in inflammatory reaction. Elevated platelet count is by itself associated with worse cardiovascular outcomes [ 78 , 79 ] and high on-treatment platelet reactivity and resistance to antiplatelet therapy [ 80 ]. This may result from more advanced inflammatory response.…”
Section: Discussionmentioning
confidence: 99%