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
. 2015;11(4):288-97.
doi: 10.5114/pwki.2015.55599. Epub 2015 Jan 12.

Platelet/lymphocyte ratio was associated with impaired myocardial perfusion and both in-hospital and long-term adverse outcome in patients with ST-segment elevation acute myocardial infarction undergoing primary coronary intervention

Cuneyt Toprak  1 , Mehmet M Tabakci  1 , Zeki Simsek  1 , Ugur Arslantas  1 , Halil I Durmus  2 , Lutfi Ocal  1 , Muhittin Demirel  1 , Burak Ozturkeri  1 , Ender Ozal  3 , Ramazan Kargin  1
Affiliations

Platelet/lymphocyte ratio was associated with impaired myocardial perfusion and both in-hospital and long-term adverse outcome in patients with ST-segment elevation acute myocardial infarction undergoing primary coronary intervention

Cuneyt Toprak et al. Postepy Kardiol Interwencyjnej. 2015.

Abstract

Introduction: Platelet/lymphocyte ratio (PLR) has been shown to be an inflammatory and thrombotic biomarker for coronary heart disease, but its prognostic value in ST-segment elevation myocardial infarction (STEMI) has not been fully investigated.

Aim: To investigate the relationship between PLR and no-reflow, along with the in-hospital and long-term outcomes in patients with STEMI.

Material and methods: In the present study, we included 304 consecutive patients suffering from STEMI who underwent primary percutaneous coronary intervention (p-PCI). Patients were stratified according to PLR tertiles based on the blood samples obtained in the emergency room upon admission. No-reflow after p-PCI was defined as a coronary thrombolysis in myocardial infarction (TIMI) flow grade ≤ 2 after vessel recanalization, or TIMI flow grade 3 together with a final myocardial blush grade (MBG) < 2.

Results: The mean follow-up period was 24 months (range: 22-26 months). The number of patients characterized with no-reflow was counted to depict increments throughout successive PLR tertiles (14% vs. 20% vs. 45%, p < 0.001). In-hospital major adverse cardiovascular events and death increased as the PLR increased (p < 0.001, p < 0.001). Long-term MACE and death also increased as the PLR increased (p < 0.001, p < 0.001). Multivariable logistic regression analysis revealed that PLR remained an independent predictor for both in-hospital (OR = 1.01, 95% CI: 1.00-1.01; p = 0.002) and major long-term (OR = 1.01, 95% CI: 1.00-1.01; p < 0.001) adverse cardiac events.

Conclusions: Platelet/lymphocyte ratio on admission is a strong and independent predictor of both the no-reflow phenomenon and long-term prognosis following p-PCI in patients with STEMI.

Keywords: ST-segment elevation acute myocardial infarction; in-hospital mortality; long-term mortality; no-reflow; platelet/lymphocyte ratio.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Receiver operating characteristic curve of PLR for predicting long-term MACE
Figure 2
Figure 2
Kaplan-Meier curves for long-term survival according to tertiles of PLR in the entire cohort of patients
See this image and copyright information in PMC

References

    1. Brosh D, Assali AR, Mager A, et al. Effect of no-reflow during primary percutaneous coronary intervention for acute myocardial infarction on six-month mortality. Am J Cardiol. 2007;99:442–5. - PubMed
    1. Bolognese L, Carrabba N, Parodi G, et al. Impact of microvascular dysfunction on left ventricular remodeling and long-term clinical outcome after primary coronary angioplasty for acute myocardial infarction. Circulation. 2004;109:1121–6. - PubMed
    1. Rezkalla SH, Kloner RA. No-reflow phenomenon. Circulation. 2002;105:656–62. - PubMed
    1. Tanboga IH, Topcu S, Aksakal E, et al. Determinants of angiographic thrombus burden in patients with ST-segment elevation myocardial infarction. Clin Appl Thromb Hemost. 2014;20:716–22. - PubMed
    1. Gürsoy OM, Karakoyun S, KalçIk M, et al. Usefulness of novel hematologic inflammatory parameters to predict prosthetic mitral valve. Am J Cardiol. 2014;113:860–4. - PubMed