Yıl: 2015 Cilt: 15 Sayı: 4 Sayfa Aralığı: 277 - 283 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome

Öz:
Objective: Platelets and inflammatory cells are vital elements of acute coronary syndromes (ACS). Recent studies have shown that the platelet-to-lymphocyte ratio (PLR) is associated with several malignancies; however, there are not enough data in cardiovascular diseases. Therefore,the aim of this study was to explore the association between PLR and in-hospital mortality in patients with ACS.Methods: We retrospectively collected patients with ACS undergoing coronary angiography. Total and differential leukocyte counts were mea-sured by an automated hematology analyzer.Results: This study is single-centered and observational. In total, 587 patients with a mean age of 61.8±13.1 years (68.4% male) were enrolledin the study. Patients were divided into 3 tertiles based on PLR levels. In-hospital mortality was significantly higher among patients in the upperPLR tertile when compared with the middle and lower PLR tertile groups [29 (14.8%) vs. 17 (8.7%) and 2 (1.0%); p<0.001]. In the multiple logisticregression analysis, a high level of PLR was an independent predictor of in-hospital mortality, together with age, total leukocyte count, andcreatinine. Using a cutoff point of 142, the PLR predicted in-hospital mortality with a sensitivity of 69% and specificity of 63%.Conclusion: Different from other inflammatory markers and assays, PLR is an inexpensive and readily available biomarker that may be usefulfor cardiac risk stratification in patients with ACS.
Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Cannon CP, Battler A, Brindis RG, Cox JL, Ellis SG, Every NR, et al. American College of Cardiology key data elements and definitions for measuring the clinical management and outcomes of patients with acute coronary syndromes: A report of the American College of Cardiology Task Force on Clinical Data Standards (Acute Coronary Syndromes Writing Committee). J Am Coll Cardiol 2001; 38: 2114-30. [CrossRef]
  • 2. Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med 2005; 352: 1685-95. [CrossRef]
  • 3. Wagner DD, Burger PC. Platelets in inflammation and thrombosis. Arterioscler Thromb Vasc Biol 2003; 23: 2131-7. [CrossRef]
  • 4. Tsiara S, Elisaf M, Jagroop IA, Mikhailidis DP. Platelets as predictor of vascular risk: is there a practical index of platelet activity? Clin Appl Thromb Hemost 2003; 9: 177-90. [CrossRef]
  • 5. Nikolsky E, Grines CL, Cox DA, Garcia E, Tcheng JE, Sadeghi M, et al. Impact of baseline platelet count in patients undergoing pri- mary percutaneous coronary intervention in acute myocardial infarction (from the CADILLAC trial). Am J Cardiol 2007; 99: 1055-61. [CrossRef]
  • 6. Iijima R, Ndrepepa G, Mehilli J, Bruskina O, Schulz S, Schömig A, et al. Relationship between platelet count and 30 day clinical out- comes after percutaneous coronary interventions. Pooled analysis of four ISAR trials. Thromb Haemost 2007; 98: 852-7. [CrossRef]
  • 7. Taleb S, Tedgui A, Mallat Z. Regulatory T-cell immunity and its rel- evance to atherosclerosis. J Intern Med 2008; 263: 489-99. [CrossRef]
  • 8. Ommen SR, Gibbons RJ, Hodge DO, Thomson SP. Usefulness of the lymphocyte concentration as a prognostic marker in coronary artery disease. Am J Cardiol 1997; 79: 812-4. [CrossRef]
  • 9. Zouridakis EG, Garcia-Moll X, Kaski JC. Usefulness of the blood lymphocyte count in predicting recurrent instability and death in patients with unstable angina pectoris. Am J Cardiol 2000; 86: 449-51. [CrossRef]
  • 10. Ommen SR, Hammill SC, Gibbons RJ. The relative lymphocyte count predicts death in patients receiving implantable cardioverter defibrillators. Pacing Clin Electrophysiol 2002; 25: 1424-8. [CrossRef]
  • 11. Sönmez O, Ertaş G, Bacaksız A, Taşal A, Erdoğan E, Aşoğlu E, et al. Relation of neutrophil -to- lymphocyte ratio with the presence and complexity of coronary artery disease: an observational study. Anatol J Cardiol 2013; 13: 662-7. [CrossRef]
  • 12. Kaya H, Ertaş F, İslamoğlu Y, Kaya Z, Atılgan ZA, Çil H, et al. Association between neutrophil to lymphocyte ratio and severity of coronary artery disease. Clin Appl Thromb Hemost 2014; 20: 50-4. [CrossRef]
  • 13. Öztürk S, Erdem A, Özlü MF, Ayhan S, Erdem K, Özyaşar M, et al. Assessment of the neutrophil to lymphocyte ratio in young patients with acute coronary syndromes. Turk Kardiyol Dern Ars 2013; 41: 284-9. [CrossRef]
  • 14. Yıldız A, Kaya H, Ertaş F, Oylumlu M, Bilik MZ, Yüksel M, et al Association between neutrophil to lymphocyte ratio and pulmo- nary arterial hypertension. Türk Kardiyol Dern Arş 2013; 41: 604-9. [CrossRef]
  • 15. Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 2008; 102: 653-7. [CrossRef]
  • 16. Azab B, Shah N, Akerman M, McGinn JT Jr. Value of platelet/lym- phocyte ratio as a predictor of all-cause mortality after non-ST- elevation myocardial infarction. J Thromb Thrombolysis 2012; 34: 326-34. [CrossRef]
  • 17. Bhatti I, Peacock O, Lloyd G, Larvin M, Hall RI. Preoperative hema- tologic markers as independent predictors of prognosis in resect- ed pancreatic ductal adenocarcinoma: neutrophil-lymphocyte versus platelet-lymphocyte ratio. Am J Surg 2010; 200: 197-203. [CrossRef]
  • 18. Wang D, Yang JX, Cao DY, Wan XR, Feng FZ, Huang HF, et al. Preoperative neutrophil-lymphocyte and platelet-lymphocyte ratios as independent predictors of cervical stromal involvement in surgically treated endometrioid adenocarcinoma. Onco Targets Ther 2013; 6: 211-6.
  • 19. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002; 105: 1135-43. [CrossRef]
  • 20. Momiyama Y, Kawaguchi A, Kajiwara I, Ohmori R, Okada K, Saito I, et al. Prognostic value of plasma high-sensitivity C-reactive pro- tein levels in Japanese patients with stable coronary artery dis- ease: the Japan NCVC-Collaborative Inflammation Cohort (JNIC) Study. Atherosclerosis 2009; 207: 272-6. [CrossRef]
  • 21. Danesh J, Collins R, Appleby P, Peto R. Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease. Meta-analyses of prospective studies. JAMA 1998; 279: 1477-82. [CrossRef]
  • 22. Gibson PH, Cuthbertson BH, Croal BL, Rae D, El-Shafei H, Gibson G, et al. Usefulness of neutrophil/lymphocyte ratio as predictor of new-onset atrial fibrillation after coronary artery bypass grafting. Am J Cardiol 2010; 105: 186-91. [CrossRef]
  • 23. Zouridakis EG, Garcia-Moll X, Kaski JC. Usefulness of the blood lymphocyte count in predicting recurrent instability and death in patients with unstable angina pectoris. Am J Cardiol 2000; 86: 449-51. [CrossRef]
  • 24. Thomson SP, McMahon LJ, Nugent CA. Endogenous cortisol: a regulator of the number of lymphocytes in peripheral blood. Clin Immunol Immunopathol 1980; 17: 506-14. [CrossRef]
  • 25. Caligiuri G, Liuzzo G, Biasucci LM, Maseri A. Immune system acti- vation follows inflammation in unstable angina: pathogenetic impli- cations. J Am Coll Cardiol 1998; 32: 1295-304. [CrossRef]
  • 26. Montalescot G, Van de Werf F, Gulba DC, Avezum A, Brieger D, Kennelly BM, et al. Stenting and glycoprotein IIb/IIIa inhibition in patients with acute myocardial infarction undergoing percutaneous coronary intervention: findings from the global registry of acute coronary events (GRACE). Catheter Cardiovasc Interv 2003; 60: 360-7. [CrossRef]
  • 27. Yusuf S, Zhao F, Mehta SR, Chrolavicius S, Tognoni G, Fox KK. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 2001; 345: 494-502. [CrossRef]
  • 28. Boersma E, Harrington RA, Moliterno DJ, White H, Théroux P, Van de Werf F, et al. Platelet glycoprotein IIb/IIIa inhibitors in acute coronary syndromes: a meta-analysis of all major randomised clinical trials. Lancet 2002; 359: 189-98. [CrossRef]
  • 29. Gawaz M, Langer H, May AE. Platelets in inflammation and athero- genesis. J Clin Invest 2005; 115: 3378-84. [CrossRef]
  • 30. Lindemann S, Kramer B, Seizer P. Gawaz M. Platelets, inflammation and atherosclerosis. J Thromb Haemost 2007; 1: 203-11. [CrossRef]
  • 31. Huo Y, Schober A, Forlow SB, Smith DF, Hyman MC, Jung S, et al. Circulating activated platelets exacerbate atherosclerosis in mice deficient in apolipoprotein E. Nat Med 2003; 9: 61-7. [CrossRef]
  • 32. Sünbül M, Gerin F, Durmuş E, Kıvrak T, Sarı I, Tigen K, et al. Neutrophil to lymphocyte and platelet to lymphocyte ratio in patients with dipper versus non-dipper hypertension. Clin Exp Hypertens 2013 Jun 20. [Epub ahead of print]
  • 33. Gary T, Pichler M, Belaj K, Hafner F, Gerger A, Froehlich H, et al. Platelet-to-lymphocyte ratio: a novel marker for critical limb isch- emia in peripheral arterial occlusive disease patients. PLoS One 2013; 8: e67688. [CrossRef]
  • 34. Bhatti I, Peacock O, Lloyd G, Larvin M, Hall RI. Preoperative hema- tologic markers as independent predictors of prognosis in resect- ed pancreatic ductal adenocarcinoma: neutrophil-lymphocyte versus platelet-lymphocyte ratio. Am J Surg 2010; 200: 197-203. [CrossRef]
  • 35. Raungkaewmanee S, Tangjitgamol S, Manusirivithaya S, Srijaipracharoen S, Thavaramara T. Platelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer. J Gynecol Oncol 2012; 23: 265-73. [CrossRef]
  • 36. Feng JF, Huang Y, Zhao Q, Chen QX. Clinical significance of preop- erative neutrophil lymphocyte ratio versus platelet lymphocyte ratio in patients with small cell carcinoma of the esophagus. ScientificWorldJournal 2013; 2013: 504365. [CrossRef]
  • 37. Franceschi C, Capri M, Monti D, Giunta S, Olivieri F, Sevini F, et al. Inflammaging and anti-inflammaging: a systemic perspective on aging and longevity emerged from studies in humans. Mech Ageing Dev 2007; 128: 92-105. [CrossRef]
  • 38. Högye M, Mándi Y, Csanády M, Sepp R, Buzás K. Comparison of circulating levels of interleukin-6 and tumor necrosis factor-alpha in hypertrophic cardiomyopathy and in idiopathic dilated cardio- myopathy. Am J Cardiol 2004; 94: 249-51. [CrossRef]
  • 39. Festa A, D’Agostino Jr R, Howard G, Mykkanen L, Tracy RP, Haffner SM. Chronic sub-clinical inflammation as part of the insulin resis- tance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation 2000; 102: 42-7. [CrossRef]
  • 40. Azab B, Zaher M, Weiserbs KF, Torbey E, Lacossiere K, Gaddam S, et al. Usefulness of neutrophil to lymphocyte ratio in predicting short- and long-term mortality after non ST elevation myocardial infarction. Am J Cardiol 2010; 106: 470-6. [CrossRef]
  • 41. Horne BD, Anderson JL, John JM, Weaver A, Bair TL, Jensen KR, et al. Intermountain Heart Collaborative Study Group. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol 2005; 45: 1638-43. [CrossRef]
  • 42. Santopinto JJ, Fox KA, Goldberg RJ, Budaj A, Piñero G, Avezum A, et al. Creatinine clearance and adverse hospital outcomes in patients with acute coronary syndromes: findings from the global registry of acute coronary events (GRACE). Heart 2003; 89: 1003-8. [CrossRef]
  • 43. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospi- talization. N Engl J Med 2004; 351: 1296-305. [CrossRef]
  • 44. Manjunath G, Tighiouart H, Ibrahim H, MacLeod B, Salem DN, Griffith JL, et al. Level of kidney function as a risk factor for athero- sclerotic cardiovascular outcomes in the community. J Am Coll Cardiol 2003; 41: 47-55. [CrossRef]
  • 45. Ahmed E, Alhabib KF, El-Menyar A, Asaad N, Sulaiman K, Hersi A, et al. Age and clinical outcomes in patients presenting with acute coronary syndromes. J Cardiovasc Dis Res 2013; 4: 134-9. [CrossRef]
APA OYLUMLU M, YILDIZ A, OYLUMLU M, Yüksel M, POLAT N, BILIK M, Akyüz A, AYDIN M, ACET H, SOYDİNÇ S (2015). Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome. , 277 - 283.
Chicago OYLUMLU Mustafa,YILDIZ Abdulkadir,OYLUMLU Muhammed,Yüksel Murat,POLAT Nihat,BILIK MEHMET ZIHNI,Akyüz Abdurrahman,AYDIN MESUT,ACET Halit,SOYDİNÇ Serdar Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome. (2015): 277 - 283.
MLA OYLUMLU Mustafa,YILDIZ Abdulkadir,OYLUMLU Muhammed,Yüksel Murat,POLAT Nihat,BILIK MEHMET ZIHNI,Akyüz Abdurrahman,AYDIN MESUT,ACET Halit,SOYDİNÇ Serdar Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome. , 2015, ss.277 - 283.
AMA OYLUMLU M,YILDIZ A,OYLUMLU M,Yüksel M,POLAT N,BILIK M,Akyüz A,AYDIN M,ACET H,SOYDİNÇ S Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome. . 2015; 277 - 283.
Vancouver OYLUMLU M,YILDIZ A,OYLUMLU M,Yüksel M,POLAT N,BILIK M,Akyüz A,AYDIN M,ACET H,SOYDİNÇ S Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome. . 2015; 277 - 283.
IEEE OYLUMLU M,YILDIZ A,OYLUMLU M,Yüksel M,POLAT N,BILIK M,Akyüz A,AYDIN M,ACET H,SOYDİNÇ S "Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome." , ss.277 - 283, 2015.
ISNAD OYLUMLU, Mustafa vd. "Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome". (2015), 277-283.
APA OYLUMLU M, YILDIZ A, OYLUMLU M, Yüksel M, POLAT N, BILIK M, Akyüz A, AYDIN M, ACET H, SOYDİNÇ S (2015). Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome. The Anatolian Journal of Cardiology, 15(4), 277 - 283.
Chicago OYLUMLU Mustafa,YILDIZ Abdulkadir,OYLUMLU Muhammed,Yüksel Murat,POLAT Nihat,BILIK MEHMET ZIHNI,Akyüz Abdurrahman,AYDIN MESUT,ACET Halit,SOYDİNÇ Serdar Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome. The Anatolian Journal of Cardiology 15, no.4 (2015): 277 - 283.
MLA OYLUMLU Mustafa,YILDIZ Abdulkadir,OYLUMLU Muhammed,Yüksel Murat,POLAT Nihat,BILIK MEHMET ZIHNI,Akyüz Abdurrahman,AYDIN MESUT,ACET Halit,SOYDİNÇ Serdar Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome. The Anatolian Journal of Cardiology, vol.15, no.4, 2015, ss.277 - 283.
AMA OYLUMLU M,YILDIZ A,OYLUMLU M,Yüksel M,POLAT N,BILIK M,Akyüz A,AYDIN M,ACET H,SOYDİNÇ S Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome. The Anatolian Journal of Cardiology. 2015; 15(4): 277 - 283.
Vancouver OYLUMLU M,YILDIZ A,OYLUMLU M,Yüksel M,POLAT N,BILIK M,Akyüz A,AYDIN M,ACET H,SOYDİNÇ S Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome. The Anatolian Journal of Cardiology. 2015; 15(4): 277 - 283.
IEEE OYLUMLU M,YILDIZ A,OYLUMLU M,Yüksel M,POLAT N,BILIK M,Akyüz A,AYDIN M,ACET H,SOYDİNÇ S "Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome." The Anatolian Journal of Cardiology, 15, ss.277 - 283, 2015.
ISNAD OYLUMLU, Mustafa vd. "Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome". The Anatolian Journal of Cardiology 15/4 (2015), 277-283.