Value of the Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio in Predicting CPET Performance in Patients with Stable CAD and Recent Elective PCI

Abstract

Background and Objectives: Functional capacity (FC) assessed via cardiopulmonary exercise testing (CPET) is a novel, independent prognostic marker for patients with coronary artery disease (CAD). Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are two readily available predictors of systemic inflammation and cardiovascular event risk, which could be used as cost-effective predictors of poor FC. The purpose of this study was to evaluate the utility of NLR and PLR in predicting poor FC in patients with CAD and recent elective percutaneous coronary intervention (PCI). Materials and Methods: Our cross-sectional retrospective analysis included 80 patients with stable CAD and recent elective PCI (mean age 55.51 ± 11.83 years, 71.3% male) who were referred to a cardiovascular rehabilitation center from January 2020 to June 2021. All patients underwent clinical examination, cardiopulmonary exercise testing on a cycle ergometer, transthoracic echocardiography and standard blood analysis. Results: Patients were classified according to percent predicted oxygen uptake (% VO2 max) in two groups—poor FC (≤70%, n = 35) and preserved FC (>70%, n = 45). There was no significant difference between groups regarding age, gender ratio, presence of associated comorbidities, left ventricular ejection fraction and NLR. PLR was higher in patients with poor FC (169.8 ± 59.3 vs. 137.4 ± 35.9, p = 0.003). A PLR cut-off point of 139 had 74% sensitivity and 60% specificity in predicting poor FC. After multivariate analysis, PLR remained a significant predictor of poor functional status. Conclusions: Although CPET is the gold standard test for assessing FC prior to cardiovascular rehabilitation, its availability remains limited. PLR, a cheap and simple test, could predict poor FC in patients with stable CAD and recent elective PCI and help prioritize referral for cardiovascular rehabilitation in high-risk patients.

Inflammatory Biomarkers as Prognostic Factors of Acute Deep Vein Thrombosis Following the Total Knee Arthroplasty

“…Hematological reports, based on neutrophil, monocyte, lymphocyte, and platelets total number: monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI), are routine inflammatory biomarkers, easy to use, with low costs. Moreover, the predictive role of these reports has been recently demonstrated in the literature in the case of cardiovascular pathology [ 24 , 25 , 26 , 27 ], pulmonary embolism [ 28 , 29 ], chronic kidney disease [ 30 , 31 , 32 ], the case of COVID-19 patients [ 33 , 34 , 35 , 36 , 37 , 38 ], as well as in the case of peri-prosthetic infection after total joint arthroplasty [ 39 , 40 , 41 ].…”

Chest CT Severity Score and Systemic Inflammatory Biomarkers as Predictors of the Need for Invasive Mechanical Ventilation and of COVID-19 Patients’ Mortality

“…Apart from well-known biomarkers of inflammation such as C-reactive protein, interleukin-6 (IL-6), and procalcitonin, hematological indices have gained popularity in recent years in the specialized literature due to their inexpensive cost and performance [ 7 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 38 , 39 , 40 , 41 ]. Moreover, hematological indices such as neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), systemic immune inflammation index (SII), Systemic Inflammation Response Index (SIRI), and Aggregate Index of Systemic Inflammation (AISI), have been applied to predict the prognosis in patients with the cardiovascular disease [ 42 , 43 , 44 ], acute limb ischemia [ 45 , 46 ], chronic kidney disease [ 47 , 48 ], peripheral artery disease [ 49 ], malignancy [ 50 , 51 , 52 ], and more recently in the case of COVID-19 patients [ 7 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ].…”

Systemic Inflammatory Biomarkers and Chest CT Findings as Predictors of Acute Limb Ischemia Risk, Intensive Care Unit Admission, and Mortality in COVID-19 Patients

“…Cell blood count (CBC) has recently been suggested and investigated in the case of COVID-19 patients as a diagnostic and predictive tool for detecting severe forms [ 31 , 32 , 33 ], the need for ICU admission [ 33 , 34 ], and the necessity for invasive mechanical ventilation (IMV) [ 35 ], as well as mortality [ 36 , 37 ]. Among the CBC parameters, we list the following inflammatory biomarkers: monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte ratio (NLR), platelets to lymphocyte ratio (PLR), systemic inflammatory index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI), whose prognostic role has been demonstrated in the field of cardio-vascular pathology [ 38 , 39 , 40 , 41 , 42 , 43 , 44 ], kidney disease [ 45 , 46 ], oncology [ 47 , 48 ], and in the last two years, in the case of COVID-19 patients [ 31 , 32 , 33 , 34 , 35 ].…”