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. 2020 Aug;8(1-2):66-74.
doi: 10.1159/000508592. Epub 2020 Jul 28.

The Role of the Platelet/Lymphocyte Ratio and Neutrophil/Lymphocyte Ratio in Predicting High-Risk Heart Score in Patients Admitted with Non-ST Elevation Acute Coronary Syndrome

Elshaimaa Seaoud  1 , Ahmed Abdel Hakim Abdelaal Mohamed  2 , Moataz A Elkot  1
Affiliations

The Role of the Platelet/Lymphocyte Ratio and Neutrophil/Lymphocyte Ratio in Predicting High-Risk Heart Score in Patients Admitted with Non-ST Elevation Acute Coronary Syndrome

Elshaimaa Seaoud et al. Pulse (Basel). 2020 Aug.

Abstract

Background: For cardiologists, management of acute chest pain continues to be a challenge. Physicians struggle to avoid unnecessary admissions and at the same time not to miss high-risk patients needing urgent intervention. Therefore, diagnostic strategies focus on identifying patients in whom an acute coronary syndrome can be safely ruled out based on findings from history, physical examination, and early cardiac marker measurement. The HEART score, a clinical prediction rule, was developed to provide the clinician with a simple and reliable predictor of cardiac risk.

Aim: This study aimed to investigate the role of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) as independent laboratory biomarkers when associated with the HEART risk score.

Method: A cross-sectional study of 120 patients who attended the emergency department with acute chest pain. NLR and PLR were both measured. In addition, the HEART score was the valid instrument used in evaluating and risk stratifying patients into low-, intermediate-, and high-risk group.

Results: There was a positive correlation between the HEART score and the mean PLR and NLR (p = 0.000*). PLR and NLR were found to be significantly higher in the high-risk HEART score group (p = 0.05 and 0.0001*, respectively). A PLR of 115.5 and above had a sensitivity of 73% and specificity of 78%, while an NLR of 3.95 and above had a sensitivity of 75% and specificity of 86% to detect high-risk HEART score patients.

Conclusion: PLR and NLR proved to be a useful tool to identify high-risk patients when validated against the HEART score.

Keywords: HEART score; Neutrophil/lymphocyte ratio; Non-ST elevation acute coronary syndrome; Platelet/lymphocyte ratio.

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Conflict of interest statement

The authors declare that they have no conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Receiver operating curve analysis showing the area under the curve for the PLR and NLR and their sensitivity and specificity in diagnosing high-risk HEART score patients. Diagonal segments are produced by ties.
See this image and copyright information in PMC

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