Inflammation marker may predict 30-day complications of acute MI
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Key takeaways:
- Platelet-to-lymphocyte ratio was tied to 30-day major adverse CV events in patients with acute MI who underwent PCI.
- The measurement could be used for risk stratification in acute MI patient groups.
Patients hospitalized for acute MI with a high platelet-to-lymphocyte ratio are up to three times more likely to experience major adverse CV events in the 30 days after undergoing PCI, researchers reported.
“Numerous studies have revealed a strong correlation between platelets to lymphocytes (PLR), a possible indicator of inflammation, and coronary artery disease (CAD), and concluded that PLR might serve as a valid predictor of mortality or major adverse cardiac events in addition to CAD,” Yi Ma, MM, of the second department of cardiology at Tangshan Gongren Hospital, China, and colleagues wrote in the study background. “Similar to the potential marker neutrophil lymphocyte ratio, which reflects inflammation and the body's stress response via a decrease in the quantity of lymphocytes, PLR ... also indicates inflammation and the activity of thrombotic processes via platelet or lymphocyte counts.”
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Ma and colleagues analyzed data from 799 patients hospitalized with acute MI who underwent a successful primary PCI within 12 hours of the onset of chest pain. Researchers stratified patients by low PLR (n = 511; controls) and high PLR (n = 288) groups using a PLR cutoff value of 178.
“The PLR ratio is calculated by dividing the absolute platelet count by the absolute lymphocyte count,” the researchers wrote. “It is a novel inflammatory marker that has the potential to be employed in the prediction of inflammation and mortality in a variety of disorders.”
At admission, total white blood cell, neutrophil, lymphocyte, and platelet counts were assessed. The primary outcome was major adverse CV events at 30 days.
The findings were published in Clinical Cardiology.
Patients with a high PLR had a higher incidence of nonfatal MI (6.94% vs. 2.35%), CV death (8.33% vs. 2.35%) and major adverse CV events (15.28% vs. 4.7%; P = .001 for all) compared with those with a low PLR. In the high PLR group, the occurrences of reinfarction, death, and major adverse CV events were approximately three times higher than in the low PLR group, according to the researchers.
In an analysis of the receiver operating characteristic curve, a PLR measurement of 178 or greater accurately predicted adverse outcomes with 73% specificity and 65% sensitivity. In logistic regression analyses, age, hypertension status and PLR were independent predictors of adverse outcomes.
“These findings showed that the PLR might be regarded as a potentially accessible, dependable, and affordable criterion for risk stratification and categorization in acute MI patient groups,” the researchers wrote.
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