Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jul 2;8(7):e67688.
doi: 10.1371/journal.pone.0067688. Print 2013.

Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients

Thomas Gary  1 , Martin Pichler, Klara Belaj, Franz Hafner, Armin Gerger, Harald Froehlich, Philipp Eller, Peter Rief, Gerald Hackl, Ernst Pilger, Marianne Brodmann
Affiliations

Platelet-to-lymphocyte ratio: a novel marker for critical limb ischemia in peripheral arterial occlusive disease patients

Thomas Gary et al. PLoS One. .

Abstract

Background: Platelet-to-Lymphocyte Ratio (PLR) is an easily applicable blood test. An elevated PLR has been associated with poor prognosis in patients with different oncologic disorder. As platelets play a key role in atherosclerosis and atherothrombosis, we investigated PLR and its association with critical limb ischemia (CLI) and other vascular endpoints in peripheral arterial occlusive disease (PAOD) patients.

Methods and findings: We evaluated 2121 PAOD patients treated at our institution from 2005 to 2010. PLR was calculated and the cohort was categorized into tertiles according to the PLR. An optimal cut-off value for the continuous PLR was calculated by applying a receiver operating curve analysis to discriminate between CLI and non-CLI. In our cohort occurrence of CLI significantly increased with an increase in PLR. As an optimal cut-off value, a PLR of 150 was identified. Two groups were categorized, one containing 1228 patients (PLR≤150) and a second group with 893 patients (PLR>150). CLI was more frequent in PLR>150 patients (410(45.9%)) compared to PLR≤150 patients (270(22.0%)) (p<0.001), as was prior myocardial infarction (51(5.7%) vs. 42(3.5%), p = 0.02). Regarding inflammatory parameters, C-reactive protein (median 7.0 mg/l (3.0-24.25) vs. median 5.0 mg/l (2.0-10.0)) and fibrinogen (median 457 mg/dl (359.0-583.0) vs. 372 mg/dl (317.25-455.75)) also significantly differed in the two patient groups (both p<0.001). Finally, a PLR>150 was associated with an OR of 1.9 (95%CI 1.7-2.1) for CLI even after adjustment for other well-established vascular risk factors.

Conclusions: An increased PLR is significantly associated with patients at high risk for CLI and other cardiovascular endpoints. The PLR is a broadly available and cheap marker, which could be used to highlight patients at high risk for vascular endpoints.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Percentage of patients with CLI stratified by tertiles of PLR. Numbers below the figure are median PLR and the 25th and 75th percentile.
See this image and copyright information in PMC

References

    1. Bertomeu V, Morillas P, Gonzalez-Juanatey JR, Quiles J, Guindo J, et al. (2008) Prevalence and prognostic influence of peripheral arterial disease in patients >or = 40 years old admitted into hospital following an acute coronary event. Eur J Vasc Endovasc Surg 36: 189–196. - PubMed
    1. Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, et al... (2007) Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg 45 Suppl S: S5–67. - PubMed
    1. Novo S, Coppola G, Milio G (2004) Critical limb ischemia: definition and natural history. Curr Drug Targets Cardiovasc Haematol Disord 4: 219–225. - PubMed
    1. Bertele V, Roncaglioni MC, Pangrazzi J, Terzian E, Tognoni EG (1999) Clinical outcome and its predictors in 1560 patients with critical leg ischaemia. Chronic Critical Leg Ischaemia Group. Eur J Vasc Endovasc Surg 18: 401–410. - PubMed
    1. Aerden D, Massaad D, von Kemp K, van Tussenbroek F, Debing E, et al. (2011) The ankle–brachial index and the diabetic foot: a troublesome marriage. Ann Vasc Surg 25: 770–777. - PubMed

MeSH terms