New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study

ÜREYEN, Çağın Mustafa; Karadag, Bilgehan; COŞANSU, KAHRAMAN; Kilic, Harun; Turer Cabbar, Ayca; GÜNDÜZ, Hüseyin; Akdemir, Ramazan

doi:10.5798/dicletip.705814

New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study

Kahraman COŞANSU, (Sakarya Üniversitesi, Eğitim ve Araştırma Hastanesi, Kardiyoloji Bölümü, Sakarya, Türkiye)

Cagın Mustafa UREYEN, (Antalya Eğitim ve Araştırma Hastanesi, Kardiyoloji Bölümü, Antalya, Türkiye)

Harun KILIÇ, (Sakarya Üniversitesi, Eğitim ve Araştırma Hastanesi, Kardiyoloji Bölümü, Sakarya, Türkiye)

Bilgehan KARADAĞ, (İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İstanbul, Türkiye)

Ayca TURER CABBAR, (Yeditepe Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İstanbul, Türkiye)

Huseyin GUNDUZ, (Sakarya Üniversitesi, Eğitim ve Araştırma Hastanesi, Kardiyoloji Bölümü, Sakarya, Türkiye)

Rmazan AKDEMİR (Sakarya Üniversitesi, Eğitim ve Araştırma Hastanesi, Kardiyoloji Bölümü, Sakarya, Türkiye)

Dicle Tıp Dergisi

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Yıl: 2020 Cilt: 47 Sayı: 1 Sayfa Aralığı: 24 - 33 Metin Dili: İngilizce DOI: 10.5798/dicletip.705814 İndeks Tarihi: 29-10-2020

New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study

Öz:

Objective: The primary aim of this study was to investigate the role of platelet-lymphocyte ratio (PLR) to predict bleedingrisk in nonvalvular atrial fibrillation (NVAF). Secondary aim was to determine the possible relation between PLR andthromboembolic and bleeding risk scores. Tertiary aim was to evaluate the predictive value of PLR for the patients in thetherapeutic international normalized ratio (INR) range.Method: PLR was calculated from the complete blood count of 228 patients who were under warfarin management forNVAF. The patients were called and it was questioned whether they had experienced the bleeding event within six monthsafter measurement of the PLR values.Correspondence/Yazışma Adresi: Kahraman Cosansu, Deparment of Cardiology, Sakarya University, Education and Research Hospital Sakarya, Turkey,54100 e-mail: kahraman141@gmail.comDOI: 10.5798/dicletip.705814Results: Bleeding event was observed in 48 patients after the PLR was calculated. It was found significantly correlationbetween PLR and CHA2DVAS2C (p<0.01) and HAS-BLED score (p<0,001). The ROC analysis showed that PLR predictedbleeding with a sensitivity of 83% and with a specificity of 84%, using a cut-off value of 165,9. The AUC (area under thecurve) for the PLR was found 0.88 (p<0.001). PLR predicted the patients in therapeutic INR range with a sensitivity of75% at ROC analysis, when using a cut-off value of 125,3 and AUC for the PLR was 0.73 (p<0.001). In the multivariateregression analysis, PLR>165,9 was determined significant indicator for bleeding (p<0.001) and showed more than a 12-fold increased risk of bleeding (12.27, [5.74-26.21]) Conclusions: The results of the present study indicate that the PLR might be a useful parameter to detect the risk ofbleeding. To our knowledge, this is the first study demonstrating the correlation of PLR with both CHA2DS2-VASc andHAS-BLED risk scores. PLR may also predict the patients within the therapeutic INR range.

Anahtar Kelime:

Non-Valvuler Atriyal Fibrilasyonu Olan Hastalarda Kanama Risk Sınıflandırılmasında Platelet-Lenfosit Oranının Yeni Kullanımları: Pilot Çalışma

Öz:

Amaç: Bu çalışmanın birincil amacı, PLR'nın NVAF'da kanama riskini tahmin etmedeki rolünü araştırmaktı. İkincil amaç, PLR ile tromboembolik ve kanama riski skorları arasındaki olası ilişkiyi belirlemekti. Üçüncül amaç, terapötik INR aralığındaki hastalar için PLR'nin prediktif değerini değerlendirmekti. Yöntemler: PLR, non-valvüler AF nedeniyle warfarin tedavisi altında olan 228 hastanın tam kan sayımından hesaplandı. PLR değerlerinin ölçümünden altı ay sonra hastalara telefon edildi ve bu altı ay içinde herhangi bir kanama olayı yaşayıp yaşamadığı sorgulandı. Bulgular: PLR hesaplandıktan sonra 48 hastada kanama olayı gözlendi. PLR ile CHA2DVAS2C (p <0.01) ve HASBLED skorları (p <0,001) arasında anlamlı bir korelasyon bulundu. ROC analizi, kesim değeri olarak 165,9 alındığında, PLR'nin kanamayı %83 hassasiyet ve %84 özgüllük ile tahmin ettiğini göstermiştir. PLR için AUC (eğrinin altındaki alan) 0,88 (p <0,001) bulundu. ROC analizinde PLR için 125,3 kesme değeri kullanıldığında, PLR %75 hassasiyetle terapötik INR aralığında bulunan hastaları öngördü ve AUC 0,73 saptandı (p <0,001). Çok değişkenli regresyon analizinde, PLR> 165,9 değeri kanama için önemli bir gösterge olarak belirlendi (p <0.001) ve 12 kattan fazla kanama riski olduğunu gösterdi (12.27, [5.74-26.21]). Sonuç: Bu çalışmanın sonuçları PLR'nin kanama riskini saptamak için yararlı bir parametre olabileceğini göstermektedir. Bildiğimiz kadarıyla, bu PLR'nin hem CHA2DS2-VASc hem de HAS-BLED risk skorları ile korelasyonunu gösteren ilk çalışmadır. PLR ayrıca terapötik INR aralığındaki hastaları da öngörebilir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	COŞANSU K, ÜREYEN Ç, Kilic H, Karadag B, Turer Cabbar A, GÜNDÜZ H, Akdemir R (2020). New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study. , 24 - 33. 10.5798/dicletip.705814
Chicago	COŞANSU KAHRAMAN,ÜREYEN Çağın Mustafa,Kilic Harun,Karadag Bilgehan,Turer Cabbar Ayca,GÜNDÜZ Hüseyin,Akdemir Ramazan New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study. (2020): 24 - 33. 10.5798/dicletip.705814
MLA	COŞANSU KAHRAMAN,ÜREYEN Çağın Mustafa,Kilic Harun,Karadag Bilgehan,Turer Cabbar Ayca,GÜNDÜZ Hüseyin,Akdemir Ramazan New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study. , 2020, ss.24 - 33. 10.5798/dicletip.705814
AMA	COŞANSU K,ÜREYEN Ç,Kilic H,Karadag B,Turer Cabbar A,GÜNDÜZ H,Akdemir R New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study. . 2020; 24 - 33. 10.5798/dicletip.705814
Vancouver	COŞANSU K,ÜREYEN Ç,Kilic H,Karadag B,Turer Cabbar A,GÜNDÜZ H,Akdemir R New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study. . 2020; 24 - 33. 10.5798/dicletip.705814
IEEE	COŞANSU K,ÜREYEN Ç,Kilic H,Karadag B,Turer Cabbar A,GÜNDÜZ H,Akdemir R "New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study." , ss.24 - 33, 2020. 10.5798/dicletip.705814
ISNAD	COŞANSU, KAHRAMAN vd. "New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study". (2020), 24-33. https://doi.org/10.5798/dicletip.705814

APA	COŞANSU K, ÜREYEN Ç, Kilic H, Karadag B, Turer Cabbar A, GÜNDÜZ H, Akdemir R (2020). New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study. Dicle Tıp Dergisi, 47(1), 24 - 33. 10.5798/dicletip.705814
Chicago	COŞANSU KAHRAMAN,ÜREYEN Çağın Mustafa,Kilic Harun,Karadag Bilgehan,Turer Cabbar Ayca,GÜNDÜZ Hüseyin,Akdemir Ramazan New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study. Dicle Tıp Dergisi 47, no.1 (2020): 24 - 33. 10.5798/dicletip.705814
MLA	COŞANSU KAHRAMAN,ÜREYEN Çağın Mustafa,Kilic Harun,Karadag Bilgehan,Turer Cabbar Ayca,GÜNDÜZ Hüseyin,Akdemir Ramazan New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study. Dicle Tıp Dergisi, vol.47, no.1, 2020, ss.24 - 33. 10.5798/dicletip.705814
AMA	COŞANSU K,ÜREYEN Ç,Kilic H,Karadag B,Turer Cabbar A,GÜNDÜZ H,Akdemir R New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study. Dicle Tıp Dergisi. 2020; 47(1): 24 - 33. 10.5798/dicletip.705814
Vancouver	COŞANSU K,ÜREYEN Ç,Kilic H,Karadag B,Turer Cabbar A,GÜNDÜZ H,Akdemir R New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study. Dicle Tıp Dergisi. 2020; 47(1): 24 - 33. 10.5798/dicletip.705814
IEEE	COŞANSU K,ÜREYEN Ç,Kilic H,Karadag B,Turer Cabbar A,GÜNDÜZ H,Akdemir R "New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study." Dicle Tıp Dergisi, 47, ss.24 - 33, 2020. 10.5798/dicletip.705814
ISNAD	COŞANSU, KAHRAMAN vd. "New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study". Dicle Tıp Dergisi 47/1 (2020), 24-33. https://doi.org/10.5798/dicletip.705814