101
|
Parlar H, Şaşkın H. Are Pre and Postoperative Platelet to Lymphocyte Ratio and Neutrophil to Lymphocyte Ratio Associated with Early Postoperative AKI Following CABG? Braz J Cardiovasc Surg 2019; 33:233-241. [PMID: 30043915 PMCID: PMC6089132 DOI: 10.21470/1678-9741-2017-0164] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 03/11/2018] [Indexed: 12/12/2022] Open
Abstract
Objective In this study, we investigated the role of two of the recent biomarkers of
inflammation on the development of acute kidney injury in the early
postoperative period of isolated coronary artery bypass grafting. Methods Three hundred and eleven patients, who underwent isolated coronary artery
bypass grafting with cardiopulmonary bypass by the same surgery team in our
clinic between May 2010 and October 2014, who had a preoperative serum
creatinine level lower than 1.5 mg/dl were included in the study. These
patients' records were reviewed retrospectively. The diagnosis of acute
kidney injury was performed according to the Kidney Disease Improving Global
Outcomes 2012 Acute Kidney Injury Guideline criteria. Patients who developed
acute kidney injury in the early postoperative period were classified as
Group-1 (n=62) and the patients with normal postoperative renal functions
were classified as Group-2 (n=249). The demographic data, body mass index,
comorbidities, hematologic/biochemical profiles, preoperative ejection
fraction, blood transfusion history, and operative data of the groups were
compared. Univariate analyses were performed to determine significant
clinical factors, and multiple logistic regression analyses were
subsequently done to determine independent predictors of acute kidney
injury. Results Sixty-two (19.9%) patients developed acute kidney injury during the first 72
hours postoperatively. Multivariate logistic regression analyses revealed
preoperative increased creatinine (P=0.0001), C-reactive
protein (P=0.02), neutrophil-lymphocyte ratio
(P=0.04) and platelet-lymphocyte ratio
(P=0.002); increased postoperative first day leukocyte
count (P=0.03), C-reactive protein levels
(P=0.02), neutrophil-lymphocyte ratio
(P=0.002), platelet-lymphocyte ratio
(P=0.01) and increased intubation time
(P=0.006) as independent predictors of early
postoperative acute kidney injury in patients who underwent isolated
coronary artery bypass grafting. Conclusion The preoperative and postoperative increased levels of neutrophil-lymphocyte
ratio and platelet-lymphocyte ratio which can be calculated by simple
methods from routine blood analysis showed us that these parameters are
independent biomarkers directly related to development of acute kidney
injury in the early postoperative period.
Collapse
Affiliation(s)
- Hakan Parlar
- Department of Cardiovascular Surgery, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Hüseyin Şaşkın
- Department of Cardiovascular Surgery, Derince Training and Research Hospital, Kocaeli, Turkey
| |
Collapse
|
102
|
High Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio are Associated with Symptomatic Internal Carotid Artery Stenosis. J Stroke Cerebrovasc Dis 2019; 28:76-83. [DOI: 10.1016/j.jstrokecerebrovasdis.2018.09.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 08/18/2018] [Accepted: 09/02/2018] [Indexed: 01/08/2023] Open
|
103
|
Decreased platelet-to-lymphocyte ratio as predictor of thrombogenesis in nonvalvular atrial fibrillation. Herz 2018; 45:684-688. [PMID: 30519706 DOI: 10.1007/s00059-018-4770-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 10/14/2018] [Accepted: 11/17/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Inflammation plays a key role in the progression of atrial fibrillation and its related prothrombotic state. The platelet-to-lymphocyte ratio (PLR) is an easily obtainable biomarker of inflammatory burden. Decreased left atrial appendage flow velocity (LAA-FV) reflects blood stasis, and left atrial strain is a manifestation of atrial remodeling. This study examined the role of PLR in reflecting decreased LAA-FV and its correlation with impaired left atrial strain. METHODS In 54 patients with nonvalvular atrial fibrillation, LAA-FV and left atrial strain were measured by echocardiography. The PLR was calculated from a complete blood count. RESULTS The PLR was lower in the group of patients with decreased LAA-FV (84.22 [IQR, 69.87-98.17 cm/s] vs. 103.27 [IQR, 90.37-127.16 cm/s]; p = 0.018). PLR was predictive of decreased LAA-FV with a sensitivity of 66.7% and a specificity of 83.3%. In a receiver operator characteristic curve analysis, using a cut-off value of 88.16, the area under the curve for PLR as a predictor of decreased LAA-FV was 0.726 (p = 0.018). Furthermore, the patients with a PLR of < 88.16 had a lower left atrial strain than those with a PLR of > 88.16 (0.38 vs. 0.77, p = 0.02). CONCLUSION The PLR was lower in patients with nonvalvular atrial fibrillation and with a decreased LAA-FV. Its correlation with left atrial strain might indicate the role of inflammation in the progression of atrial remodeling and in the prothrombotic state.
Collapse
|
104
|
Inflammation is correlated with severity and outcome of cerebral venous thrombosis. J Neuroinflammation 2018; 15:329. [PMID: 30477534 PMCID: PMC6260678 DOI: 10.1186/s12974-018-1369-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 11/15/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Few studies have suggested a relationship between inflammation and cerebral venous thrombosis (CVT). This retrospective study aimed to explore the changes in inflammation in different CVT stages and the correlation between inflammation and severity and outcome of CVT. METHODS In total, 95 suitable patients with CVT and 41 controls were compared. Patients with CVT were divided into three groups. The inflammatory factors studied included hypersensitive C-reactive protein (Hs-CRP), interleukin-6 (IL-6), and neutrophil-to-lymphocyte ratio (NLR) in the peripheral blood and immunoglobulin A (IgA), immunoglobulin M (IgM), and immunoglobulin G (IgG) in the cerebrospinal fluid (CSF). The severity of CVT was evaluated with the modified Rankin Scale (mRS), the National Institutes of Health Stroke Scale (NIHSS), fundus condition, intracranial pressure (ICP), and complications on admission. The short-term outcome was evaluated with the mRS at discharge. RESULTS The following results were obtained: (1) Inflammatory factor levels in patients with CVT were higher than those in the controls. (2) Inflammatory factor levels in the acute and subacute stages were significantly higher than those in the chronic stage (all P < 0.05). (3) Serum NLR and CSF IgM levels were positively related to baseline degree of disability (odds ratio [OR], 1.279, 95% confidence interval [CI] 1.009-1.621, P = 0.042; OR 1.402, 95% CI 1.036-1.896, P = 0.028). The Hs-CRP level was positively correlated with the baseline occurrence of seizure (OR 1.040, 95% CI 1.001-1.080, P = 0.043). The baseline serum NLR (r = 0.244, P = 0.017), CSF IgA (r = 0.615, P < 0.001), CSF IgM (r = 0.752, P < 0.001), and CSF IgG (r = 0.248, P = 0.015) levels were positively associated with NIHSS. (4) The baseline NLR was significantly associated with high risk of poor outcome at discharge (OR 1.339, 95% CI 1.097-1.784, P = 0.007). Moreover, the ROC showed that NLR ≥ 4.205 could better predict the poor outcome at discharge. The data were analyzed using SPSS. CONCLUSIONS Inflammation may develop after CVT and gradually decrease during the course. Inflammation was significantly correlated with severity on admission and short-term poor outcome at discharge in CVT.
Collapse
|
105
|
Kofink D, Muller SA, Patel RS, Dorresteijn JAN, Berkelmans GFN, de Groot MCH, van Solinge WW, Haitjema S, Leiner T, Visseren FLJ, Hoefer IE, Asselbergs FW. Routinely measured hematological parameters and prediction of recurrent vascular events in patients with clinically manifest vascular disease. PLoS One 2018; 13:e0202682. [PMID: 30192769 PMCID: PMC6128486 DOI: 10.1371/journal.pone.0202682] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 08/06/2018] [Indexed: 12/25/2022] Open
Abstract
Background and aims The predictive value of traditional risk factors for vascular events in patients with manifest vascular disease is limited, underscoring the need for novel biomarkers to improve risk stratification. Since hematological parameters are routinely assessed in clinical practice, they are readily available candidates. Methods We used data from 3,922 vascular patients, who participated in the Second Manifestations of ARTerial Disease (SMART) study. We first investigated associations between recurrent vascular events and 22 hematological parameters, obtained from the Utrecht Patient Oriented Database (UPOD), and then assessed whether parameters associated with outcome improved risk prediction. Results After adjustment for all SMART risk score (SRS) variables, lymphocyte %, neutrophil count, neutrophil % and red cell distribution width (RDW) were significantly associated with vascular events. When individually added to the SRS, lymphocyte % improved prediction of recurrent vascular events with a continuous net reclassification improvement (cNRI) of 17.4% [95% CI: 2.1, 32.1%] and an increase in c-statistic of 0.011 [0.000, 0.022]. The combination of lymphocyte % and neutrophil count resulted in a cNRI of 22.2% [3.2, 33.4%] and improved c-statistic by 0.011 [95% CI: 0.000, 0.022]. Lymphocyte % and RDW yielded a cNRI of 18.7% [3.3, 31.9%] and improved c-statistic by 0.016 [0.004, 0.028]. However, the addition of hematological parameters only modestly increased risk estimates for patients with an event during follow-up. Conclusions Several hematological parameters were independently associated with recurrent vascular events. Lymphocyte % alone and in combination with other parameters enhanced discrimination and reclassification. However, the incremental value for patients with a recurrent event was limited.
Collapse
Affiliation(s)
- Daniel Kofink
- Department of Cardiology, University Medical Utrecht, University of Utrecht, Utrecht, the Netherlands
| | - Steven A. Muller
- Department of Cardiology, University Medical Utrecht, University of Utrecht, Utrecht, the Netherlands
| | - Riyaz S. Patel
- Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, United Kingdom
- The Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom
| | - Jannick A. N. Dorresteijn
- Department of Vascular Medicine, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | - Gijs F. N. Berkelmans
- Department of Vascular Medicine, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | - Mark C. H. de Groot
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands
| | - Wouter W. van Solinge
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | - Saskia Haitjema
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | - Tim Leiner
- Department of Radiology, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | - Frank L. J. Visseren
- Department of Vascular Medicine, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | - Imo E. Hoefer
- Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands
| | - Folkert W. Asselbergs
- Department of Cardiology, University Medical Utrecht, University of Utrecht, Utrecht, the Netherlands
- Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, United Kingdom
- Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, the Netherlands
- * E-mail:
| | | |
Collapse
|
106
|
Platelet to Lymphocyte Ratio on Admission and Prognosis in Patients with Acute Cardiogenic Pulmonary Edema. J Emerg Med 2018; 55:465-471. [PMID: 30115388 DOI: 10.1016/j.jemermed.2018.06.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 06/01/2018] [Accepted: 06/12/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Acute heart failure is a heterogenous syndrome defined by a number of factors, such as its physiopathology, clinical picture, time of onset, and relation to acute coronary syndrome. Acute cardiogenic pulmonary edema (ACPE) constitutes approximately 10-20% of acute heart failure syndromes, and it is the most dramatic symptom of left heart failure. Platelet to lymphocyte ratio (PLR) is a relatively novel inflammatory marker that can be utilized for prognosis in various disease processes. OBJECTIVE In this study, we investigated the value of the PLR for the prediction of mortality in patients with ACPE. METHODS A total of 115 patients hospitalized with a diagnosis of ACPE were included in this study. The patients were divided into tertile groups according to their PLR values: high (PLR > 194.97), medium (98.3-194.97), and low tertile (PLR < 98.3). RESULTS We compared the PLR groups for in-hospital mortality and total mortality after discharge. Multivariate Cox regression analysis showed that PLR was independently associated with total mortality (hazard ratio 5.657; 95% confidence interval 2.467-12.969; p < 0.001). Survival analysis using the Kaplan-Meier curve showed that the high-PLR group had a significantly higher mortality rate than the other groups. CONCLUSIONS We showed an association between high PLR and mortality in patients with ACPE. PLR, together with other inflammatory markers and clinical findings, may be used as an adjunctive parameter for the stratification of mortality risk, hospitalization, or discharge criteria scoring.
Collapse
|
107
|
Can neutrophil to lymphocyte ratio and platelet to lymphocyte ratio be used as biomarkers for non-dipper blood pressure? JOURNAL OF SURGERY AND MEDICINE 2018. [DOI: 10.28982/josam.436951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
108
|
Zhang W, Shen Y. Platelet-to-Lymphocyte Ratio as a New Predictive Index of Neurological Outcomes in Patients with Acute Intracranial Hemorrhage: A Retrospective Study. Med Sci Monit 2018; 24:4413-4420. [PMID: 29946059 PMCID: PMC6052826 DOI: 10.12659/msm.910845] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Systemic inflammation plays a critical role in the pathophysiological process of intracranial hemorrhage (ICH). Recently, the platelet-to-lymphocyte ratio (PLR) has become a research focus that indicates inflammation in various diseases. Thus, this study aimed to investigate the predictive value of PLR in patients with acute ICH. MATERIAL AND METHODS This study was performed in a single teaching hospital. Glasgow coma scale at hospital discharge (GCSdis) and modified Rankin score (MRS) at 6 months were recorded as short-term and long-term neurological outcomes. Ordered and binary logistic regression methods were used to explore the associations. RESULTS Finally, data on 183 ICH patients were included. A knot of PLR around 100 was detected and applied in the extended ordered logistic regression models. For PLR >100, PLR on ICU admission was significantly associated with worse GCSdis (from Model 1: OR: 1.004, 95% CI 1.001-1.007 to Model 4: OR: 1.006, 95% CI 1.002-1.009) while the PLR on Emergency Department (ED) admission was insignificant. For PLR ≤100, neither the PLR on ICU or ED admission was associated with GCSdis level. In the quartile grouping analysis, PLR Q2 was used as a reference level. Both Q3 and Q4 on ICU admission were significantly associated with lower GCSdis level (OR, 3.30; 95%CI 1.38-7.88; and OR, 3.79; 95%CI 1.54-9.33, respectively), while Q1 was insignificant. All 4 quartiles of PLR on ED admission were not associated with GCSdis. CONCLUSIONS Only higher PLR value on ICU admission but not on ED admission was associated with worse GCSdis.
Collapse
Affiliation(s)
- Weimin Zhang
- Intensive Care Unit, Dongyang People's Hospital, Dongyang, Zhejiang, China (mainland)
| | - Yanfei Shen
- Intensive Care Unit, Dongyang People's Hospital, Dongyang, Zhejiang, China (mainland)
| |
Collapse
|
109
|
Usefulness of Platelet-to-Lymphocyte Ratio to Predict Long-Term All-Cause Mortality in Patients at High Risk of Coronary Artery Disease Who Underwent Coronary Angiography. Am J Cardiol 2018; 121:1021-1026. [PMID: 29606325 DOI: 10.1016/j.amjcard.2018.01.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 01/02/2018] [Accepted: 01/08/2018] [Indexed: 01/24/2023]
Abstract
Platelet-to-lymphocyte ratio (PLR) has recently been studied as a biomarker in patients with established coronary artery disease (CAD). The association between PLR and long-term all-cause mortality is unclear in patients at high risk of CAD who undergo coronary angiography for various indications. Follow-up was completed for 514 patients who underwent coronary angiography in a prospective study cohort. The primary end point was all-cause mortality. Patients were classified into tertiles based on preangiography PLR and also dichotomized based on the optimal cutoff at a PLR of 137, determined from the receiver operating characteristic curve analysis. The mean follow-up period was 5.0 ± 1.3 years, with 50 all-cause deaths. On the Kaplan-Meier analysis, patients in Tertile 3 (PLR > 145) had worse prognosis than patients in Tertiles 1 (PLR ≤ 106) and 2 (PLR 106.1 to 145) (p = 0.0075), and patients with PLR ≥ 137 had a significantly higher rate of all-cause mortality than those with PLR < 137 (p = 0.0006). On multivariate Cox regression adjusting for known cardiovascular risk factors, PLR was a strong, independent predictor of long-term all-cause mortality on the tertile analysis (Tertile 3 vs Tertile 1: hazard ratio 2.52, 95% confidence interval 1.18 to 5.39, p = 0.017) and based on the cutoff at a PLR of 137 (PLR ≥ 137 vs <137: hazard ratio 2.25, 95% confidence interval 1.21 to 4.20, p = 0.011). In conclusion, elevated PLR is associated with long-term all-cause mortality in patients at high risk of CAD who undergo coronary angiography, and PLR may be a useful prognostic biomarker in this population.
Collapse
|
110
|
Sbarouni E, Georgiadou P, Kosmas E, Analitis A, Voudris V. Platelet to lymphocyte ratio in acute aortic dissection. J Clin Lab Anal 2018; 32:e22447. [PMID: 29603401 DOI: 10.1002/jcla.22447] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 03/09/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Inflammation plays an important role in the initiation and progression of acute aortic dissection (AAD). New inflammatory indices derived from full cell blood count and its differential may be associated with increased risk. We evaluated platelet-lymphocyte (PLR), red cell distribution width (RDW) and RDW/PLT's (platelets) (RPR) in AAD. METHODS We studied 120 consecutive patients with AAD type I admitted for emergency surgery (group I), 121 consecutive patients with aortic aneurysms of the ascending aorta prior to elective repair (group II) and 121 controls (group III), age and sex matched. RESULTS PLR was significantly higher in group I vs both groups II and III (P < .001). There was an excellent correlation of PLR with neutrophil/lymphocyte ratio (NLR) in all three groups (P < .001 for all). After adjustment for hemoglobin, RDW did not differ but RPR remained significantly higher in group I compared to groups II and III (P < .001). The best cutoff value of PLR to predict dissection was 159 with 53% sensitivity and 86% specificity. No association between PLR, RDW, and RPR and mortality in group I was found. CONCLUSIONS Indices derived from full cell blood count may provide diagnostic information in patients with AAD; whether these indices may contribute to prognosis assessment should be further investigated.
Collapse
Affiliation(s)
- Eftihia Sbarouni
- 2nd Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
| | - Panagiota Georgiadou
- 2nd Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
| | - Elias Kosmas
- 2nd Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece
| | - Vassilis Voudris
- 2nd Division of Interventional Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
| |
Collapse
|
111
|
Wang Z, Ren L, Liu N, Peng J. Utility of Hematological Parameters in Predicting No-Reflow Phenomenon After Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction. Clin Appl Thromb Hemost 2018; 24:1177-1183. [PMID: 29552915 PMCID: PMC6714744 DOI: 10.1177/1076029618761005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective: Because the no-reflow phenomenon in patients with ST- segment elevation myocardial infarction can lead to poor outcomes and early identification of patients at high risk may alter the clinical outcome, we aimed to study possible differences in the predictive utility among hematological parameters for early identification of patients at high risk of the no-reflow phenomenon during the primary percutaneous coronary intervention. Methods: A total of 612 patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention were enrolled. The patients were divided into 2 groups: no-reflow and normal reflow. Hematological parameters were measured on admission. Sensitivity, specificity, positive and negative predictive values, and receiver–operating characteristic areas under the curve were determined to evaluate the predictive values of these parameters. Results: The patients in the no-reflow group had a significantly higher neutrophil count, neutrophil–lymphocyte ratio, platelet–lymphocyte ratio, and mean platelet volume-to-lymphocyte ratio when compared to the normal reflow patients. We identified mean platelet volume-to-lymphocyte ratio to have a moderate predictive value and high specificity (66.8%) for the no-reflow phenomenon. Neutrophil–lymphocyte ratio provided the largest area under the curve for predicting no reflow. Regarding the predictive utility for no reflow, the comparison showed no statically significant differences among evaluated hematological parameters. Conclusion: For the prediction of no reflow, mean platelet volume-to-lymphocyte ratio yielded moderate performance. No hematological parameter on admission had persuasive superior capacities to predict no-reflow in patients receiving the primary percutaneous coronary intervention.
Collapse
Affiliation(s)
- Zuoyan Wang
- 1 Department of Cardiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Lihui Ren
- 1 Department of Cardiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Na Liu
- 2 Department of Clinical Laboratory, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Jianjun Peng
- 1 Department of Cardiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
112
|
Tham T, Rahman L, Persaud C, Olson C, Costantino P. Venous Thromboembolism Risk in Head and Neck Cancer: Significance of the Preoperative Platelet-to-Lymphocyte Ratio. Otolaryngol Head Neck Surg 2018; 159:85-91. [PMID: 29406795 DOI: 10.1177/0194599818756851] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective We aimed to investigate the association between the preoperative platelet-to-lymphocyte ratio (PLR) and venous thromboembolism (VTE) in patients with head and neck cancer (HNC) undergoing major surgery. Study Design Retrospective cohort study. Setting Academic tertiary hospital from 2011 to 2017. Subjects and Methods Patients with confirmed HNC undergoing major surgery were included in this study. The preoperative PLR was recorded for all patients. Known VTE risk factors, including Caprini score, age, sex, smoking, body mass index, prior VTE, and anticoagulation, were also recorded. Risk factors were screened in univariate analysis using Wilcoxon's rank sum test and χ2 test (Bonferroni corrected). Significant covariates were included in a multivariate regression model. Bootstrap techniques were used to obtain credible confidence intervals (CIs). Results There were 306 patients enrolled with 7 cases of VTE (6 deep vein thromboses and 1 pulmonary embolism. On univariate analysis, length of stay ( P = .0026), length of surgery ( P = .0029), and PLR ( P = .0002) were found to have significant associations with VTE. A receiver operator characteristic (ROC) curve was constructed that yielded an area under the ROC of 0.905 (95% CI, 0.82-0.98). Using an optimized cutoff, the multivariate model showed that length of surgery (β 95% CI, 0.0001-0.0006; P = .0056) and PLR (β 95% CI, 5.3256-5.3868; P < .0001) were significant independent predictors of VTE. Conclusion This exploratory pilot study has shown that PLR offers a potentially accurate risk stratification measure as an adjunct to current tools in VTE risk prediction, without additional cost to health systems.
Collapse
Affiliation(s)
- Tristan Tham
- 1 Department of Otolaryngology, New York Head and Neck Institute, Zucker School of Medicine at Hofstra/Northwell, New York, New York, USA
| | - Lauren Rahman
- 1 Department of Otolaryngology, New York Head and Neck Institute, Zucker School of Medicine at Hofstra/Northwell, New York, New York, USA
| | - Christina Persaud
- 1 Department of Otolaryngology, New York Head and Neck Institute, Zucker School of Medicine at Hofstra/Northwell, New York, New York, USA
| | - Caitlin Olson
- 1 Department of Otolaryngology, New York Head and Neck Institute, Zucker School of Medicine at Hofstra/Northwell, New York, New York, USA
| | - Peter Costantino
- 1 Department of Otolaryngology, New York Head and Neck Institute, Zucker School of Medicine at Hofstra/Northwell, New York, New York, USA
| |
Collapse
|
113
|
Li C, Shen Y, Xu R, Dai Y, Chang S, Lu H, Dong Z, Deng J, Qian J, Ge J. Evaluation of Preprocedural Laboratory Parameters as Predictors of Drug-Eluting Stent Restenosis in Coronary Chronic Total Occlusion Lesions. Angiology 2018; 70:272-278. [PMID: 29338303 DOI: 10.1177/0003319717752245] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
This retrospective, single-center study assessed the prognostic value of several emerging inflammatory markers as predictors of in-stent restenosis (ISR) after drug-eluting stent implantation for coronary chronic total occlusion (CTO) lesions. Consecutive patients (n = 416) who underwent successful percutaneous coronary intervention (PCI) for documented CTO lesions and with follow-up angiography were enrolled. Preprocedural high-sensitivity C-reactive protein (hsCRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red cell distribution width (RDW) were analyzed. At mean follow-up of 14.4 ± 3.3 months, ISR occurred in 72 patients. Compared with the non-ISR group, preprocedural hsCRP level, PLR, NLR, and RDW were significantly higher in the ISR group. The ISR group also had significantly greater proportions of patients with diabetes and smoking history, lower estimated glomerular filtration rate, higher low-density lipoprotein cholesterol (LDL-C) level and neutrophil count, longer stent length, and higher rate of severe dissection. In multivariate analysis, NLR (odds ratio [OR]: 3.110; 95% confidence interval [CI], 2.102-4.063; P < .001) and PLR (OR: 1.029; 95% CI, 1.016-1.143; P < .001) were independent predictors of ISR, along with LDL-C level and stent length. In conclusion, higher preprocedural NLR and PLR levels were independent risk factors for the development of ISR in patients who underwent PCI for CTO lesions.
Collapse
Affiliation(s)
- Chenguang Li
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Yi Shen
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Rende Xu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Yuxiang Dai
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Shufu Chang
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Hao Lu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Zhaohui Dong
- Department of Cardiology, Fengcheng Hospital, Shanghai, China
| | - Jianxin Deng
- Department of Cardiology, Fengcheng Hospital, Shanghai, China
| | - Juying Qian
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| |
Collapse
|
114
|
Sambel M, Kilic M, Demirbas M, Onen E, Oner S, Erdogan A, Aydos MM. Relationship between erectile dysfunction and the neutrophil to lymphocyte and platelet to lymphocyte ratios. Int J Impot Res 2017; 30:27-35. [DOI: 10.1038/s41443-017-0007-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 06/30/2017] [Accepted: 08/25/2017] [Indexed: 12/22/2022]
|
115
|
Higher Platelet-to-Lymphocyte Ratio Increased the Risk of Sarcopenia in the Community-Dwelling Older Adults. Sci Rep 2017; 7:16609. [PMID: 29192175 PMCID: PMC5709494 DOI: 10.1038/s41598-017-16924-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 11/20/2017] [Indexed: 12/18/2022] Open
Abstract
The platelet-to-lymphocyte ratio (PLR) has been extensively studied in oncologic diseases. However, the correlation between PLR and sarcopenia remains unknown. In this cross-sectional analysis, we enrolled 3,671 non-institutionalized individuals from the National Health and Nutrition Examination Survey (NHANES) III (1988–1994) aged ≥60 years and whose complete blood counts (CBCs), body composition measurements, and related demographic information was available. Skeletal muscle mass was assessed using a previously published equation (including age, sex, height, and bioelectrical impedance analysis). PLR values were estimated based on laboratory data. Multiple linear and logistic regression analyses, quartile-based stratified odds ratio comparisons, and trend tests were performed. Elevations in serum PLR values were significantly associated with sarcopenia status and negatively associated with skeletal muscle index. After additionally adjusting for other covariates, the significant negative correlation remained; moreover, participants with highest serum PLR values (≥155) had 2.36 times greater risk of sarcopenia than those with lowest PLR values (<90; odds ratio (OR) = 2.36; 95% confidence interval (CI): 1.21–3.31; p < 0.01). Higher PLR levels are associated with a greater risk of sarcopenia in geriatric populations. Thus, PLR as an inexpensive and easily measurable parameter can be considered as an inflammatory biomarker for sarcopenia.
Collapse
|
116
|
Hudzik B, Szkodziński J, Korzonek-Szlacheta I, Wilczek K, Gierlotka M, Lekston A, Zubelewicz-Szkodzińska B, Gąsior M. Platelet-to-lymphocyte ratio predicts contrast-induced acute kidney injury in diabetic patients with ST-elevation myocardial infarction. Biomark Med 2017; 11:847-856. [PMID: 28976786 DOI: 10.2217/bmm-2017-0120] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
AIM There has been a rise in contrast-induced acute kidney injury (CI-AKI). We examined the role of platelet-to-lymphocyte ratio (PLR) in predicting CI-AKI episodes in patients with myocardial infarction (MI) and diabetes. METHODS A total of 719 patients with diabetes and MI were enrolled. Study population was divided into: group 1 (n = 615) without CI-AKI and group 2 (n = 104) with CI-AKI. RESULTS Patients with CI-AKI had higher in-hospital mortality and a longer in-hospital stay. Median PLR was higher in patients with CI-AKI. Receiver operating characteristic analysis indicated PLR to be a good predictive tool in assessing the risk of CI-AKI. PLR was an independent predictor of CI-AKI (OR: 1.22; p < 0.0001). CONCLUSION These results suggest potential role for PLR as a biomarker of CI-AKI among diabetic patients with MI who undergo percutaneous coronary intervention.
Collapse
Affiliation(s)
- Bartosz Hudzik
- Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Disease, Zabrze, Poland.,Department of Nutrition-Related Disease Prevention, School of Public Health in Bytom, Medical University of Silesia in Katowice, Bytom, Poland
| | - Janusz Szkodziński
- Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Disease, Zabrze, Poland
| | - Ilona Korzonek-Szlacheta
- Department of Nutrition-Related Disease Prevention, School of Public Health in Bytom, Medical University of Silesia in Katowice, Bytom, Poland
| | - Krzysztof Wilczek
- Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Disease, Zabrze, Poland
| | - Marek Gierlotka
- Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Disease, Zabrze, Poland
| | - Andrzej Lekston
- Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Disease, Zabrze, Poland
| | - Barbara Zubelewicz-Szkodzińska
- Department of Nutrition-Related Disease Prevention, School of Public Health in Bytom, Medical University of Silesia in Katowice, Bytom, Poland
| | - Mariusz Gąsior
- Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Disease, Zabrze, Poland
| |
Collapse
|
117
|
Budzianowski J, Pieszko K, Burchardt P, Rzeźniczak J, Hiczkiewicz J. The Role of Hematological Indices in Patients with Acute Coronary Syndrome. DISEASE MARKERS 2017; 2017:3041565. [PMID: 29109595 PMCID: PMC5646322 DOI: 10.1155/2017/3041565] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 08/21/2017] [Indexed: 02/08/2023]
Abstract
An increased systemic and local inflammation plays a key role in the pathophysiology of acute coronary syndrome (ACS). This review will discuss the role of hematological indices: white blood cells (WBC), neutrophil to lymphocyte ratio (NLR), red cell distribution width (RDW), and platelet indices, that is, platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet distribution width (PDW) in the case of ACS. In recent years, a strong interest has been drawn to these indices, given that they may provide independent information on pathophysiology, risk stratification, and optimal management. Their low-cost and consequent wide and easy availability in daily clinical practice have made them very popular in the laboratory testing. Furthermore, many studies have pointed at their effective prognostic value in all-cause mortality, major cardiovascular events, stent thrombosis, arrhythmias, and myocardial perfusion disorders in terms of acute myocardial infarction and unstable angina. The most recent research also emphasizes their significant value in the combined analysis with other markers, such as troponin, or with GRACE, SYNTAX, and TIMI scores, which improve risk stratification and diagnosis in ACS patients.
Collapse
Affiliation(s)
| | - Konrad Pieszko
- Department of Cardiology, Hospital Nowa Sól, Nowa Sól, Poland
| | - Paweł Burchardt
- Department of Biology and Environmental Sciences, Poznań University of Medical Sciences, Poznań, Poland
- Department of Cardiology, J. Struś Hospital, Poznań, Poland
| | | | | |
Collapse
|
118
|
Prognostic value of platelet-to-lymphocyte ratios among critically ill patients with acute kidney injury. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2017; 21:238. [PMID: 28882170 PMCID: PMC5590135 DOI: 10.1186/s13054-017-1821-z] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 08/22/2017] [Indexed: 12/21/2022]
Abstract
Background Inflammation plays an important role in the initiation and progression of acute kidney injury (AKI). However, evidence regarding the prognostic effect of the platelet-to-lymphocyte ratio (PLR), a novel systemic inflammation marker, among patients with AKI is scarce. In this study, we investigated the value of the PLR in predicting the outcomes of critically ill patients with AKI. Methods Patient data were extracted from the Multiparameter Intelligent Monitoring in Intensive Care Database III version 1.3. PLR cutoff values were determined using smooth curve fitting or quintiles and were used to categorize the subjects into groups. The clinical outcomes were 30-day and 90-day mortality in the intensive care unit (ICU). Cox proportional hazards models were used to evaluate the association between the PLR and survival. Results A total of 10,859 ICU patients with AKI were enrolled. A total of 2277 thirty-day and 3112 ninety-day deaths occurred. A U-shaped relationship was observed between the PLR and both 90-day and 30-day mortality, with the lowest risk being at values ranging from 90 to 311. The adjusted HR (95% CI) values for 90-day mortality given risk values < 90 and > 311 were 1.25 (1.12–1.39) and 1.19 (1.08–1.31), respectively. Similar trends were observed for 30-day mortality or when quintiles were used to group patients according to the PLR. Statistically significant interactions were found between the PLR and both age and heart rate. Younger patients (aged < 65 years) and those with more rapid heart rates (≥89.4 beats per minute) tended to have poorer prognoses only when the PLR was < 90, whereas older patients (aged ≥ 65 years) and those with slower heart rates (<89.4 beats per minute) had higher risk only when the PLR was > 311 (P < 0.001 for age and P < 0.001 for heart rate). Conclusions The preoperative PLR was associated in a U-shaped pattern with survival among patients with AKI. The PLR appears to be a novel, independent prognostic marker of outcomes in critically ill patients with AKI.
Collapse
|
119
|
Yao C, Liu X, Tang Z. Prognostic role of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio for hospital mortality in patients with AECOPD. Int J Chron Obstruct Pulmon Dis 2017; 12:2285-2290. [PMID: 28814856 PMCID: PMC5546734 DOI: 10.2147/copd.s141760] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background and objectives Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is one of the leading causes of hospitalization and is associated with considerable mortality, for which clinicians are seeking useful and easily obtained biomarkers for prognostic evaluation. This study aimed to determine the potential role of the neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) as prognostic makers for hospital mortality in patients with AECOPD. Methods We included 303 patients with AECOPD in this retrospective study. Clinical characteristics, NLR, PLR, and serum levels of C-reactive protein (CRP) and other data were collected. Relationships between NLR/PLR and CRP were evaluated by Pearson’s correlation test. Receiver operating characteristics curve and the area under the curve (AUC) were used to assess the ability of NLR and PLR to predict hospital mortality in patients with AECOPD. Results Mean levels of NLR and PLR of all patients with AECOPD were 7.92±8.79 and 207.21±148.47, respectively. NLR levels correlated with serum CRP levels (r=0.281, P<0.05). The overall hospital mortality rate was 12.21% (37/303). Levels of NLR and PLR were signifi-cantly higher among non-survivors compared to survivors of AECOPD (both P<0.05). At a cut-off value of 6.24, the sensitivity and specificity of the NLR in predicting hospital mortality were 81.08% and 69.17%, respectively, with an AUC of 0.803. At a cut-off of 182.68, the corresponding sensitivity, specificity and AUC of PLR were 64.86%, 58.27%, and 0.639. The combination of NLR, PLR, and CRP increased the prognostic sensitivity. Conclusion NLR and PLR levels were increased in non-survivor patients with AECOPD, and the NLR may be simple and useful prognostic marker for hospital mortality in patients with AECOPD. More studies should be carried out to confirm our findings.
Collapse
Affiliation(s)
- CaoYuan Yao
- Department of Respiratory Medicine, Yongchuan Hospital, Chongqing Medical University
| | - XiaoLi Liu
- Diabetes Department, Yongchuan Traditional Chinese Medical Hospital
| | - Ze Tang
- Department of Critical Care Medicine, Yongchuan Hospital, Chongqing Medical University, Chongqing, China
| |
Collapse
|
120
|
Białas AJ, Pedone C, Piotrowski WJ, Antonelli Incalzi R. Platelet distribution width as a prognostic factor in patients with COPD - pilot study. Int J Chron Obstruct Pulmon Dis 2017; 12:2261-2267. [PMID: 28814854 PMCID: PMC5546588 DOI: 10.2147/copd.s131868] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Platelets may actively participate in inflammation in COPD. Platelet distribution width (PDW), a measure of platelets’ volume heterogeneity, may increase in platelets’ activation. We hypothesized that PDW may be a marker of hypercoagulation, which plays a significant role in conditions associated with worse survival of patients with COPD, eg, acute myocardial infarction and other forms of ischemic heart disease. Methods Retrospective analysis of 79 patients. Variables were compared after grouping patients according to the upper normal limit of PDW, using Welch’s t-tests or Mann–Whitney U, and chi-square tests. Survival in the two groups was compared using the Kaplan–Meier method and Cox proportional hazards regression. Results Ten patients presented values of PDW above 16 fL, which was the upper limit of normality for our laboratory. Compared to patients with normal PDW, they had lower forced expiratory flow between 25% and 75% of vital capacity (FEF 25–75) – 35% of reference value vs 57% (P=0.003) and peak expiratory flow – 39% vs 54% (P<0.001). The median survival of patients with elevated PDW was 743 days compared to those with normal PDW (1,305 days) (P=0.025). The adjusted HR was 4.59 (95% CI: 1.1, 19.19; P=0.04). Conclusion Our analysis indicates that elevated PDW is associated with reduced survival of patients with COPD. If our data are to be confirmed, PDW may be used as an inexpensive and repeatable prognostic tool in COPD.
Collapse
Affiliation(s)
- Adam J Białas
- Department of Pneumology and Allergy, Medical University of Lodz, Łódź, Poland.,Healthy Aging Research Centre (HARC), Medical University of Lodz, Łódź, Poland
| | - Claudio Pedone
- Department of Geriatrics, Campus Bio-Medico University of Rome, Rome, Italy
| | - Wojciech J Piotrowski
- Department of Pneumology and Allergy, Medical University of Lodz, Łódź, Poland.,Healthy Aging Research Centre (HARC), Medical University of Lodz, Łódź, Poland
| | | |
Collapse
|
121
|
Usefulness of platelet to lymphocyte and neutrophil to lymphocyte ratios in predicting the presence of cerebral venous sinus thrombosis and in-hospital major adverse cerebral events. J Neurol Sci 2017; 380:226-229. [PMID: 28870575 DOI: 10.1016/j.jns.2017.07.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 07/07/2017] [Accepted: 07/25/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND Platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) as recently emerging thrombo-inflammatory indicators were significantly associated with both major cerebrovascular/cardiovascular adverse events (MACE) and mortality. Therefore, we aimed to assess the effects of combinations of PLR and NLR in predicting the presence of CVST and in-hospital MACE. METHODS A total of 277 participants comprising 80 patients with evidence of CVST and 197 controls with similar baseline characteristics were included in this retrospective study. Patients were classified into 3 groups based on the optimal cut-off values of PLR and NLR calculated with receiver operating characteristic (ROC) curve for in-hospital MACE rates. RESULTS PLR (148±61 vs 101±50, p<0.001) and NLR (3.12±1.4 vs 1.94±1.1, p<0.001) were significantly higher in the CVST group. Furthermore, patients in the high risk group (a PLR of ≥115.0 and an NLR of ≥2.1) had the highest in-hospital MACE rates including seizure (p=0.012), papilledema (p=0.025) and diplopia or blurry vision (p=0.028). After multivariate logistic regression analysis MPV, PLR (1.052 [1.045-1.059], p=0.001) and NLR (1.442 [1.086-1.916], p=0.012) were found as independent predictors of CVST. CONCLUSION These results suggest that PLR and NLR are easily available and cheap thrombo-inflammatory indicators, so that PLR and NLR could be used in prediction of CVST and in-hospital MACE.
Collapse
|
122
|
Avci A, Avci D, Erden F, Ragip E, Cetinkaya A, Ozyurt K, Atasoy M. Can we use the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and mean platelet volume values for the diagnosis of anterior uveitis in patients with Behcet's disease? Ther Clin Risk Manag 2017; 13:881-886. [PMID: 28769565 PMCID: PMC5529084 DOI: 10.2147/tcrm.s135260] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The purpose of this study was to compare the value of hematological parameters, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV), as indicators of anterior uveal segment involvement in patients with Behcet’s disease (BD). Patients and methods Hospital-based records of a total of 912 patients with BD from the dermatology clinic and healthy volunteers from the checkup clinic were assessed retrospectively. After applying the exclusion criteria of the study, 71 of the BD patients with anterior uveitis, 69 of the BD patients without ophthalmological pathology and 151 healthy volunteers were included in the study. MPV, PLR, and NLR values of patients and healthy volunteers were compared. Results All MPV, PLR, and NLR values of patients who had anterior uveitis were significantly higher than those of other patients and healthy volunteers. Statistically, considering area under curves (ratio): NLR was 0.725 (0.653–0.797), P<0.001; PLR was 0.600 (0.523–0.676), P=0.012, and MPV was 0.358 (0.279–0.437), P<0.001. Conclusion MPV, PLR, and NLR are all valuable for assessment of anterior uveal segment involvement in patients with BD. However, the NLR seems to be better than the PLR and MPV for indicating anterior uveitis due to BD.
Collapse
Affiliation(s)
- Atil Avci
- Department of Dermatology and Venereology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Deniz Avci
- Internal Medicine Department, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Fatma Erden
- Department of Dermatology and Venereology, Cubuk State Hospital, Ankara, Turkey
| | - Ertas Ragip
- Department of Dermatology and Venereology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Ali Cetinkaya
- Internal Medicine Department, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Kemal Ozyurt
- Department of Dermatology and Venereology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Mustafa Atasoy
- Department of Dermatology and Venereology, Kayseri Training and Research Hospital, Kayseri, Turkey
| |
Collapse
|
123
|
Wang X, Xie Z, Liu X, Huang X, Lin J, Huang D, Yu B, Hou J. Association of Platelet to lymphocyte ratio with non-culprit atherosclerotic plaque vulnerability in patients with acute coronary syndrome: an optical coherence tomography study. BMC Cardiovasc Disord 2017; 17:175. [PMID: 28673240 PMCID: PMC5496410 DOI: 10.1186/s12872-017-0618-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 06/27/2017] [Indexed: 01/09/2023] Open
Abstract
Background The platelet to lymphocyte ratio (PLR), an indirect inflammatory biomarker, has been recently demonstrated to be associated with severity of coronary artery disease. In the present study, we sought to investigate whether PLR is associated with vulnerable plaque characteristics of non-culprit lesions in patients with acute coronary syndrome (ACS). Methods The patients in our study were divided into two groups (high PLR group and low PLR group). A total of 119 non-culprit plaques from 71 patients with ACS were assessed by optical coherence tomography (OCT). Results The non-culprit plaques in high PLR group exhibited thinner fibrous cap thickness (FCT) (88.60 ± 44.70 vs. 119.28 ± 50.22 μm, P = 0.001), greater maximum lipid arc (271.73 ± 71.66 vs. 240.60 ± 76.69°, P = 0.027) and increased incidence of thin-cap fibroatheroma (TCFA) (34.0% vs. 15.9%, P = 0.022) compared with those in low PLR group. Meanwhile, PLR was negatively associated with FCT (r = −0.329, P < 0.001). Furthermore, multivariate regression analysis showed that PLR [OR: 1.023 (95% CI: 1.005–1.041), P = 0.012] and LDL-C [OR: 1.892 (95% CI: 1.106–3.239), P = 0.020] were significant predictors of TCFA. Conclusions High level of PLR may be associated with vulnerable plaque features of non-culprit lesions in patients with ACS. PLR, a cheap and easily available index, may surve as a useful inflammatory marker in reflecting plaque vulnerability.
Collapse
Affiliation(s)
- Xuedong Wang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.,Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, 150001, China
| | - Zulong Xie
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Xinxin Liu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.,Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, 150001, China
| | - Xingtao Huang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.,Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, 150001, China
| | - Jiale Lin
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.,Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, 150001, China
| | - Dan Huang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.,Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, 150001, China
| | - Bo Yu
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.,Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, 150001, China
| | - Jingbo Hou
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China. .,Key Laboratory of Myocardial Ischemia, Ministry of Education, Harbin Medical University, Harbin, 150001, China.
| |
Collapse
|
124
|
Kosyakov SY, Kirdeeva AI. [The etiopathogenetic aspects of idiopathic sensorineural impairment of hearing]. Vestn Otorinolaringol 2017; 82:95-101. [PMID: 28514375 DOI: 10.17116/otorino201681695-101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The objectives of the present work were the overview of the results of the modern investigations concerning etiology of idiopathic sensorineural impairment of hearing as well as the analysis of the theory of microthrombus formation and its role in pathogenesis of hearing impairment.
Collapse
Affiliation(s)
- S Ya Kosyakov
- Russian Medical Academy for Post-Graduate Education, Moscow, Russia, 125993
| | - A I Kirdeeva
- Russian Medical Academy for Post-Graduate Education, Moscow, Russia, 125993
| |
Collapse
|
125
|
Sengul EA, Artunay O, Kockar A, Afacan C, Rasier R, Gun P, Yalcin NG, Yuzbasioglu E. Correlation of neutrophil/lymphocyte and platelet/lymphocyte ratio with visual acuity and macular thickness in age-related macular degeneration. Int J Ophthalmol 2017; 10:754-759. [PMID: 28546933 DOI: 10.18240/ijo.2017.05.16] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 04/20/2017] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate the place of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in the diagnosis of and prognosis for neovascular age-related macular degeneration (AMD). METHODS One hundred AMD patients and 100 healthy controls were included in the study. Blood samples were obtained from the venous blood, which is used for routine analysis, and these samples were subjected to complete blood count. NLR was defined as the neutrophil count divided by the number of lymphocytes, and PLR was defined as the platelet count divided by the number of lymphocytes. RESULTS No statistically significant difference was observed between the two groups under consideration in terms of demographic features (P>0.05). The average NLR in the patient group was found to be significantly higher than that in the healthy control group (P<0.05). The average PLR was significantly higher in the patient group as compared to the control group (P<0.05). As best corrected visual acuity (BCVA) increased, both NLR and PLR decreased (significant negative correlations at 49.8% and 63.0%, respectively), whereas as central macular thickness (CMT) increased, both NLR and PLR increased (significant positive correlations at 59.3% and 70.0%, respectively). CONCLUSION NLR and PLR levels are higher among neovascular AMD patients as compared to healthy control group. NLR and PLR levels were found to be inversely proportional to BCVA and directly proportional to CMT.
Collapse
Affiliation(s)
- Elvan Alper Sengul
- Ophthalmology Department, Medical Faculty, Istanbul Bilim University, Istanbul 34381, Turkey
| | - Ozgur Artunay
- Ophthalmology Department, Haydarpasa Numune Training and Research Hospital, Istanbul 34668, Turkey
| | - Alev Kockar
- Ophthalmology Department, Medical Faculty, Istanbul Bilim University, Istanbul 34381, Turkey
| | - Ceyda Afacan
- Department of Statistics, Mimar Sinan Fine Arts University, Istanbul 34427, Turkey
| | - Rifat Rasier
- Ophthalmology Department, Medical Faculty, Istanbul Bilim University, Istanbul 34381, Turkey
| | - Palmet Gun
- Biochemistry Department, Medical Faculty, Istanbul Bilim University, Istanbul 34381, Turkey
| | - Nazli Gul Yalcin
- Ophthalmology Department, Medical Faculty, Istanbul Bilim University, Istanbul 34381, Turkey
| | - Erdal Yuzbasioglu
- Ophthalmology Department, Medical Faculty, Istanbul Bilim University, Istanbul 34381, Turkey
| |
Collapse
|
126
|
Vakili H, Shirazi M, Charkhkar M, Khaheshi I, Memaryan M, Naderian M. Correlation of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio with thrombolysis in myocardial infarction frame count in ST-segment elevation myocardial infarction. Eur J Clin Invest 2017; 47:322-327. [PMID: 28177528 DOI: 10.1111/eci.12736] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 02/04/2017] [Indexed: 01/26/2023]
Abstract
BACKGROUND Impaired coronary artery reflow after primary percutaneous coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction has been associated with postintervention adverse effects. Thus, finding an easily achievable index would be of great value to predict no-reflow phenomenon. In this regard, platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) have been introduced. In this study, we aimed to investigate correlation of PLR and NLR with thrombolysis in myocardial infarction (TIMI) frame count. MATERIALS AND METHODS A total of 215 consecutive patients with ST-segment elevation myocardial infarction (STEMI) were recruited. Pre-intervention laboratory tests were performed. Moreover, PLR and NLR were calculated for each patient. Ultimately, TIMI frame count was assessed subsequent to primary PCI for each patient. RESULTS We found that both PLR and NLR are correlated with TIMI frame count (R: 0·372, P < 0·001 and R: 0·301, P < 0·001, respectively). Furthermore, it was revealed that both PLR and NLR are positively correlated with corrected TIMI frame count (R: 0·388, P < 0·001 and R: 0·290, P < 0·001, respectively). CONCLUSIONS PLR and NLR are two easily calculated and efficient indexes for predicting the no-reflow phenomenon in patients with STEMI undergoing PPCI. Therefore, they might be employed in accurate risk stratification when a patient is a candidate for PPCI and in accurately referring patients who would benefit greatly from PPCI.
Collapse
Affiliation(s)
- Hossein Vakili
- Cardiovascular Research Center, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahin Shirazi
- Cardiovascular Research Center, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Charkhkar
- Cardiovascular Research Center, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Isa Khaheshi
- Cardiovascular Research Center, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Memaryan
- Cardiovascular Research Center, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Naderian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
127
|
Usefulness of the platelet-to-lymphocyte ratio in predicting long-term cardiovascular mortality in patients with peripheral arterial occlusive disease. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2017; 13:32-38. [PMID: 28344615 PMCID: PMC5364280 DOI: 10.5114/aic.2017.66184] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 10/24/2016] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Inflammation and increased platelet activation play a crucial role in the initiation and progression of atherosclerosis. Platelet-to-lymphocyte ratio (PLR) has recently been reported as a new independent predictor for major adverse cardiovascular events in cardiovascular diseases. AIM To investigate the relation between PLR and cardiovascular mortality in patients with intermittent claudication or critical limb ischemia (CLI) or both. MATERIAL AND METHODS In our retrospective study, 602 consecutive patients who were admitted to a large tertiary hospital with the diagnosis of symptomatic peripheral arterial occlusive disease (PAOD) were included. Patients were divided into two groups according to their PLR as follows: high PLR (PLR > 142) and low PLR (PLR ≤ 142) groups. RESULTS During the follow-up period (median: 33.8 months (interquartile range: 21-45)), 131 deaths occurred out of 602 (21.8%) patients. Cardiovascular mortality was found to be significantly higher in the high PLR group compared to the low PLR group (31.6% vs. 17.2 %; p < 0.001). Even after adjustment for various risk factors, PLR > 142 and age were found to be independent predictors of long-term cardiovascular mortality in Cox regression analysis (hazard ratios (95% confidence interval): 1.03 (1.01-1.04) and 1.04 (1.02-1.06), p < 0.001 and p < 0.001, respectively). CONCLUSIONS Platelet-to-lymphocyte ratio, which is one of the parameters of routine complete blood count, reflects increased inflammatory status, platelet activation and aggregation. PLR is a cheap and readily available marker that has the ability to improve risk stratification provided by conventional risk scores in predicting long-term cardiovascular mortality in PAOD.
Collapse
|
128
|
Raffetti E, Donato F, Casari S, Castelnuovo F, Sighinolfi L, Bandera A, Maggiolo F, Ladisa N, di Pietro M, Fornabaio C, Digiambenedetto S, Quiros-Roldan E. Systemic inflammation-based scores and mortality for all causes in HIV-infected patients: a MASTER cohort study. BMC Infect Dis 2017; 17:193. [PMID: 28264665 PMCID: PMC5339992 DOI: 10.1186/s12879-017-2280-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 02/21/2017] [Indexed: 12/12/2022] Open
Abstract
Background Two biomarkers, the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), have been shown to be indicative of systemic inflammation and predictive of mortality in general population. We aimed to assess the association of NLR and PLR, with risk of death in HIV-infected subjects when also taking account of HIV-related factors. Methods We conducted a multicenter Italian cohort study from 2000 to 2012 including HIV-infected subjects naïve at antiretroviral treatment. The associations of NLR and PLR with all-cause mortality were tested by univariate and multivariate analyses using both time independent and dependent Cox proportional hazard models. We also fitted models with a cubic-spline for PLR and NLR to evaluate the possible non-linear relationship between biomarkers values and risk of death. Results Eight-thousand and two hundred thirty patients (73.1% males) with a mean age of 38.4 years (SD 10.1) were enrolled. During a median follow-up of 3.9 years, 539 patients died. PLR < 100 and ≥ 200, as compared to PLR of 100–200, and NLR ≥ 2, as compared to < 2, were associated with risk of death at both univariate and multivariate analyses. Using multivariate models with restricted cubic-splines, we found a linear relationship of increasing risk of death with increasing values for NRL over 1.1, and an U-shape curve for PLR, with higher mortality risk for values higher or lower than 120. Conclusions Our data suggest that NLR and PLR can reflect the severity of the underlying systemic disturbance of the inflammatory process and coagulation leading to augmented mortality in HIV positive subjects. Electronic supplementary material The online version of this article (doi:10.1186/s12879-017-2280-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Elena Raffetti
- Unit of Hygiene, Epidemiology and Public Health, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa 11, 25123, Brescia, Italy.
| | - Francesco Donato
- Unit of Hygiene, Epidemiology and Public Health, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa 11, 25123, Brescia, Italy
| | - Salvatore Casari
- University Division of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy
| | - Filippo Castelnuovo
- Hospital Division of Infectious and Tropical Diseases, Spedali Civili General Hospital, Brescia, Italy
| | - Laura Sighinolfi
- Clinical Infectious Diseases of "Azienda Ospedaliera S. Anna" of Ferrara, Ferrara, Italy
| | - Alessandra Bandera
- Clinic of Infectious Diseases, San Gerardo de' Tintori Hospital, Monza, Italy
| | - Franco Maggiolo
- Clinical Infectious Diseases of "Ospedale Papa Giovanni XXIII" of Bergamo, Bergamo, Italy
| | | | - Massimo di Pietro
- Clinical Infectious Diseases of "Azienda Ospedaliera S. Anna" of Ferrara, Ferrara, Italy
| | - Chiara Fornabaio
- Clinical Infectious Diseases of "Istituti Ospitalieri" of Cremona, Cremona, Italy
| | | | - Eugenia Quiros-Roldan
- University Division of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy
| |
Collapse
|
129
|
Bonello L, Laine M, Baccini V, Frere C. Parameters of complete blood count do not predict on-treatment platelet reactivity in acute coronary syndrome patients. Thromb Res 2017; 152:38-40. [PMID: 28219844 DOI: 10.1016/j.thromres.2017.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 02/05/2017] [Accepted: 02/10/2017] [Indexed: 10/20/2022]
Affiliation(s)
- Laurent Bonello
- Assistance Publique-Hôpitaux de Marseille, Department of Cardiology, Hôpital Nord, Marseille, France; Mediterranean Academic association for Research and Studies in Cardiology (MARS Cardio), Marseille, France; Aix-Marseille University, INSERM, UMRS 1076, Marseille, France.
| | - Marc Laine
- Assistance Publique-Hôpitaux de Marseille, Department of Cardiology, Hôpital Nord, Marseille, France; Mediterranean Academic association for Research and Studies in Cardiology (MARS Cardio), Marseille, France; Aix-Marseille University, INSERM, UMRS 1076, Marseille, France
| | - Véronique Baccini
- Assistance Publique-Hôpitaux de Marseille, Department of Haematology, Marseille, France; Aix-Marseille University, INSERM, UMRS 1062, Marseille, France
| | - Corinne Frere
- Assistance Publique-Hôpitaux de Marseille, Department of Haematology, Marseille, France; Aix-Marseille University, INSERM, UMRS 1076, Marseille, France
| |
Collapse
|
130
|
Li W, Liu Q, Tang Y. Platelet to lymphocyte ratio in the prediction of adverse outcomes after acute coronary syndrome: a meta-analysis. Sci Rep 2017; 7:40426. [PMID: 28071752 PMCID: PMC5223131 DOI: 10.1038/srep40426] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 12/05/2016] [Indexed: 12/17/2022] Open
Abstract
Recent studies have shown platelet to lymphocyte ratio (PLR) to be a potential inflammatory marker in cardiovascular diseases. We performed a meta-analysis to systematically evaluate the prognostic role of PLR in acute coronary syndrome (ACS). A comprehensive literature search up to May 18, 2016 was conducted from PUBMED, EMBASE and Web of science to identify related studies. The risk ratio (RR) with 95% confidence interval (CI) was extracted or calculated for effect estimates. Totally ten studies involving 8932 patients diagnosed with ACS were included in our research. We demonstrated that patients with higher PLR level had significantly higher risk of in-hospital adverse outcomes (RR = 2.24, 95%CI = 1.81–2.77) and long-term adverse outcomes (RR = 2.32, 95%CI = 1.64–3.28). Sensitivity analyses confirmed the stability of our results. We didn’t detect significant publication bias by Begg’s and Egger’s test (p > 0.05). In conclusion, our meta-analysis revealed that PLR is promising biomarker in predicting worse prognosis in ACS patients. The results should be validated by future large-scale, standard investigations.
Collapse
Affiliation(s)
- Wenzhang Li
- Department of Cardiology, First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Qianqian Liu
- Department of Respiratory Diseases, Chengdu Municipal First People's Hospital, Chengdu, Sichuan, China
| | - Yin Tang
- State Key Laboratory of Oral Disease, West China School &Hospital of Stomotology, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
131
|
Kilic A, Kurtul A. RETRACTED: Mean Platelet Volume-to-Lymphocyte Ratio as a Novel Marker for Severity and Complexity of Coronary Atherosclerosis in Patients With Acute Coronary Syndrome. Angiology 2017; 69:3319717724274. [PMID: 28774187 DOI: 10.1177/0003319717724274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Alparslan Kilic
- 1 Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Alparslan Kurtul
- 1 Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| |
Collapse
|
132
|
Gungor H, Babu AS, Zencir C, Akpek M, Selvi M, Erkan MH, Durmaz S. Association of Preoperative Platelet-to-Lymphocyte Ratio with Atrial Fibrillation after Coronary Artery Bypass Graft Surgery. Med Princ Pract 2017; 26:164-168. [PMID: 27875817 PMCID: PMC5588364 DOI: 10.1159/000453614] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 11/21/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the association between platelet-to-lymphocyte ratio (PLR) and atrial fibrillation (AF) after coronary artery bypass graft (CABG) surgery. SUBJECTS AND METHODS A total of 125 patients were retrospectively analyzed. AF was diagnosed using standard clinical criteria, and PLR was calculated as the ratio of the platelets to lymphocytes, obtained from the blood samples that were taken in the fasting state before CABG surgery. The association of different variables with postoperative AF and PLR was calculated using univariate and multivariate analysis. The receiver operating characteristics curve was used to determine the sensitivity and specificity of PLR and the optimal cutoff value for predicting post-CABG AF. RESULTS Of the 125 patients, 50 with AF (mean age: 67.0 ± 9.5 years, 38 males and 12 females) and 75 patients without AF (mean age: 61.1 ± 9.1 years, 58 males and 17 females) were identified, and the difference in the mean age was statistically significant (p = 0.01). PLR was also significantly higher in those with AF (152.8 ± 82.2) than those without AF (118.2 ± 32.9) (p = 0.012). Univariate analysis showed that age and PLR were associated with AF after CABG surgery (p < 0.001 and p = 0.005, respectively). Using a multivariate logistic regression model with the backward elimination method, age and PLR remained as independent predictors of AF after CABG surgery (p < 0.001 and p = 0.005, respectively). PLR levels >119.3 predicted postoperative AF with 64% sensitivity and 56% specificity (AUC: 0.634, p = 0.012). CONCLUSION In this study, age and PLR level were independent predictors of AF after CABG surgery. Patients with an elevated preoperative PLR were at higher risk of AF after CABG surgery.
Collapse
Affiliation(s)
- Hasan Gungor
- Department of Cardiology, Manipal, India
- *Hasan Gungor, MD, Department of Cardiology, Faculty of Medicine, Adnan Menderes University, TR-09100 Aydin (Turkey), E-Mail
| | - Abraham Samuel Babu
- Department of Department of Physiotherapy, School of Allied Health Sciences, Manipal University, Manipal, India
| | | | | | | | - Muhammet Huseyin Erkan
- Department of Cardiovascular Surgery, Adnan Menderes University, Aydin, Turkey, Manipal, India
| | - Selim Durmaz
- Department of Cardiovascular Surgery, Adnan Menderes University, Aydin, Turkey, Manipal, India
| |
Collapse
|
133
|
Ozcan Cetin EH, Cetin MS, Canpolat U, Akdi A, Aras D, Temizhan A, Aydogdu S. Platelet-to-lymphocyte ratio as a novel marker of in-hospital and long-term adverse outcomes among patients with acute pulmonary embolism: A single center large-scale study. Thromb Res 2016; 150:33-40. [PMID: 28011405 DOI: 10.1016/j.thromres.2016.12.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 11/25/2016] [Accepted: 12/08/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND The interaction of platelets with leukocytes is a well-known process both in progression and prognosis of acute pulmonary embolism (PE). Recently, platelet to lymphocyte ratio (PLR) is emerged as an indirect inflammatory indicator which was shown to be associated with adverse cardiovascular events in various clinical conditions, including acute PE. However, the long-term prognostic value of PLR in acute PE has not been investigated thoroughly. Therefore, we aimed to assess the impact of PLR on both in-hospital and long-term adverse outcomes in acute PE. METHODS A total of 459 patients with definite diagnosis of acute PE between January 2009 and January 2016 were enrolled. On admission, blood sampling to calculate PLR and detailed clinical data were obtained. Patients were divided into tertiles according to the admission PLR levels. Simplified PE severity index (sPESI) score and computerized tomography (CT) based pulmonary artery obstruction index were calculated for each patient. RESULTS Mean sPESI score of the study population was 1.6. A total of 34 patients (7.4%) died during index hospitalization. At median 28.8months follow-up, all-cause mortality was observed in 81 patients (1.9%). Patients in the highest tertile of PLR revealed a higher rate of in-hospital adverse events including cardiogenic shock, the necessity for thrombolytic therapy and in-hospital mortality as well as long-term all-cause mortality. In multivariate analysis, the PLR was found to be a significant predictor of both in-hospital adverse events (OR: 1.588, 95% CI:1.116-2.154, p=0.004) and long-term all-cause mortality (OR:1.746, 95% CI:1.211-2.865, p=0.001). CONCLUSIONS The PLR, as a simple, inexpensive and available marker of inflammatory and prothrombotic status, seemed to be a novel predictor of in-hospital and long-term adverse outcomes in patients with acute PE.
Collapse
Affiliation(s)
- Elif Hande Ozcan Cetin
- Turkey Yuksek Ihtisas Training and Research Hospital, Cardiology Department, Ankara, Turkey.
| | - Mehmet Serkan Cetin
- Turkey Yuksek Ihtisas Training and Research Hospital, Cardiology Department, Ankara, Turkey
| | - Ugur Canpolat
- Hacettepe University Faculty of Medicine, Department of Cardiology, Ankara, Turkey
| | - Ahmet Akdi
- Turkey Yuksek Ihtisas Training and Research Hospital, Cardiology Department, Ankara, Turkey
| | - Dursun Aras
- Turkey Yuksek Ihtisas Training and Research Hospital, Cardiology Department, Ankara, Turkey
| | - Ahmet Temizhan
- Turkey Yuksek Ihtisas Training and Research Hospital, Cardiology Department, Ankara, Turkey
| | - Sinan Aydogdu
- Turkey Yuksek Ihtisas Training and Research Hospital, Cardiology Department, Ankara, Turkey
| |
Collapse
|
134
|
Uçar FM, Açar B, Gul M, Özeke Ö, Aydogdu S. The Association between Platelet/Lymphocyte Ratio and Coronary Artery Disease Severity in Asymptomatic Low Ejection Fraction Patients. Korean Circ J 2016; 46:821-826. [PMID: 27826341 PMCID: PMC5099338 DOI: 10.4070/kcj.2016.46.6.821] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 03/17/2016] [Accepted: 04/12/2016] [Indexed: 12/25/2022] Open
Abstract
Background and Objectives Coronary angiography (CAG) is generally needed in the setting of systolic heart failure (HF) with an unidentified etiology as a part of diagnostic strategy. On the other hand, the clinical value of this invasive strategy is largely unknown. Platelet-lymphocyte ratio (PLR) has recently emerged as a novel inflammatory index that may serve as an important predictor of inflammatory state and overall mortality. The present study aimed to search the predictive value of PLR in determining the extent of coronary atherosclerosis in asymptomatic low ejection fraction (EF) patients. Subjects and Methods 156 asymptomatic heart failure (HF) subjects (without angina or HF symptoms, mean age: 58 years; to male: 71.2%) were enrolled, and thereafter a CAG was performed. Gensini Score was used to determine the severity of coronary artery disease (CAD) on CAG. According to this scoring system, the overall study group was categorized into three distinct subgroups: control group with the score 0, mild atherosclerosis group with the score 0 to 20 and severe atherosclerosis group with the score of >20. Thereafter, a comparison was made among groups with regard to mean values of PLR. Results The severe atherosclerosis group had a substantially higher level of mean PLR in comparison to other groups (p<0.001). Pre-CAG PLR levels as well as a variety of clinical variables including age, low density lipoprotein (LDL)-cholesterol demonstrated an independent correlation with Gensini score through a multivariate analysis. Conclusion These findings suggest the potential association of high PLR levels with severe atherosclerosis in the setting of asymptomatic systolic HF. A simple measurement of PLR helps to identify the severity of coronary atherosclerosis prior to conducting coronary angiography.
Collapse
Affiliation(s)
- Fatih Mehmet Uçar
- Department of Cardiology, Trakya University Hospital, Edirne, Turkey
| | - Burak Açar
- Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Murat Gul
- Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Özcan Özeke
- Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Sinan Aydogdu
- Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
135
|
Gayret OB, Erol M, Tekin Nacaroglu H. The Relationship of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio with Gastrointestinal Bleeding in Henoch-Schonlein Purpura. IRANIAN JOURNAL OF PEDIATRICS 2016; 26:e8191. [PMID: 28203340 PMCID: PMC5297442 DOI: 10.5812/ijp.8191] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 09/06/2016] [Accepted: 10/01/2016] [Indexed: 01/26/2023]
Abstract
Objectives Henoch-Schonlein Purpura (HSP) is the most widespread systemic vasculitis during childhood. Gastrointestinal tract retention and gastrointestinal bleeding are among its major complications. Neutrophil-Lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are indicators related to inflammatory diseases. This study evaluated the relationship between NLR or PLR and gastrointestinal bleeding in HSP. Methods The study consisted of 119 patients and 40 healthy children in the same age group. White Blood Cell (WBC) count, hemoglobin level, platelet count, mean platelet volume (MPV), neutrophil count and lymphocyte count were recorded. The NLR and PLR were calculated based on the results of complete blood count tests performed during the first visit to the hospital. Results The average neutrophil count and NLR of the patients with HSP were found to be significantly increased compared to the control group (P = 0.0001). No significant difference was observed between the PLR average of HSP and control groups (P = 0.053). Platelet count average (P = 0.0001) and PLR (P = 0.001) of the patients with gastrointestinal system (GIS) bleeding were found to be statistically significantly increased compared to those who did not have gastrointestinal bleeding. No significant difference was found in the NLR of the patients with and without gastrointestinal bleeding (P = 0.060). Conclusions While the NLR was significantly increased in patients with HSP in this study, the PLR was found to be more significant in patients with gastrointestinal bleeding. Similar to NLR, PLR may also be used as an inflammatory indicator among children with HSP, who have gastrointestinal bleeding.
Collapse
Affiliation(s)
- Ozlem Bostan Gayret
- Bagcilar Training and Research Hospital, Department of Pediatrics, Istanbul, Turkey
- Corresponding author: Ozlem Bostan Gayret, Bagcilar Training and Research Hospital, Department of Pediatrics, Istanbul, Turkey. Tel: +90-5327633326, E-mail:
| | - Meltem Erol
- Bagcilar Training and Research Hospital, Department of Pediatrics, Istanbul, Turkey
| | - Hikmet Tekin Nacaroglu
- Bagcilar Training and Research Hospital, Department of Pediatric Allergy, Istanbul, Turkey
| |
Collapse
|
136
|
The relation of platelet-lymphocyte ratio and coronary collateral circulation in patients with non-ST segment elevation myocardial infarction. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2016; 12:224-30. [PMID: 27625685 PMCID: PMC5011538 DOI: 10.5114/aic.2016.61644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 06/30/2015] [Indexed: 01/17/2023] Open
Abstract
Introduction Recently, platelet-to-lymphocyte ratio (PLR) has emerged as a significant inflammatory marker and a novel predictor of major adverse consequences in cardiovascular disease. Aim In this study, we aimed to explore the relationship between PLR and coronary collateral circulation (CCC) in patients with non-ST elevation myocardial infarction (NSTEMI). Material and methods Clinical and laboratory data of 386 patients who underwent coronary angiography were evaluated retrospectively. The patients were classified into 2 groups as follows: poor CCC (group 1: Rentrop grades 0–1) and good CCC (group 2: Rentrop grades 2–3). The PLR was calculated from the complete blood count. Results The PLR values of the patients with poor CCC were significantly higher than those of patients with good CCC (153.9 ±26.6 vs. 129.8 ±23.5, p < 0.001). In the multiple logistic regression tests, PLR (odds ratio: 1.51, 95% confidence interval: 1.27–1.74; p < 0.001) and hs-CRP (odds ratio: 1.56, 95% CI: 1.03–2.11; p < 0.001) were found to be independent predictors of poor CCC. The receiver operating characteristic (ROC) curve analysis yielded a cutoff value of 140.5 for PLR to predict poor CCC with 79% sensitivity and 71% specificity, with the area under the ROC curve being 0.792 (95% CI: 0.721–0.864). Conclusions Our study revealed that high PLR is independently associated with poor coronary collateral circulation in patients with NSTEMI.
Collapse
|
137
|
Sarlak H, Arslan E, Cakar M, Tanriseven M, Ozenc S, Akhan M, Bulucu F. Relation between unconjugated bilirubin and RDW, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio in Gilbert's syndrome. SPRINGERPLUS 2016; 5:1392. [PMID: 27610311 PMCID: PMC4993745 DOI: 10.1186/s40064-016-3085-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 08/16/2016] [Indexed: 01/24/2023]
Abstract
Background Unconjugated bilirubin (UCB) plays a protective role in coronary artery disease. Red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are inflammatory biomarkers and higher levels are related to atherosclerosis and adverse cardiovascular events. Aim We aimed to investigate the relation between UCB levels and RDW, NLR, PLR in people with Gilbert’s syndrome (GS).
Materials and methods We selected 2166 subjects (1082 with GS and 1084 healthy controls) from a database having 33,695 people. RDW, NLR and PLR were investigated in the subjects with GS and compared with the healthy controls. Linear regression analysis was used to evaluate the relation between variables. Results NLR and PLR were higher in the subjects with GS compared to the controls (p < 0.001). RDW was similar in both groups (p = 0.318). UCB was negatively correlated with lymphocyte counts (p = 0.040), and positively correlated with RDW (p < 0.001) and PLR (p = 0.037) in the subjects with GS. There was no significant correlation between UCB and NLR (p = 0.078). RDW (p < 0.001) and lymphocyte counts (p = 0.030) were significantly associated with UCB levels in the regression analysis conducted in the subjects with GS. Conclusion There is a negative association between UCB and NLR, PLR due to low amounts of lymphocyte counts, which causes increased risk of CVD. These results suggest that the cardio-protective effect of UCB is due to both anti-oxidative and anti-inflammatory ways indirectly.
Collapse
Affiliation(s)
- Hakan Sarlak
- Internal Medicine Service, Diyarbakır Military Hospital, Seref Inaloz Street, Yenisehir, 21100 Diyarbakir, Turkey
| | - Erol Arslan
- Department of Internal Medicine, Gulhane Military Medical Faculty, Ankara, Turkey
| | - Mustafa Cakar
- Department of Rheumatology, Gulhane Military Medical Faculty, Ankara, Turkey
| | - Mustafa Tanriseven
- General Surgery Service, Diyarbakır Military Hospital, Diyarbakir, Turkey
| | - Salim Ozenc
- Family Medicine Service, Diyarbakır Military Hospital, Diyarbakir, Turkey
| | - Muharrem Akhan
- Department of Internal Medicine, Gulhane Military Medical Faculty, Ankara, Turkey
| | - Fatih Bulucu
- Department of Internal Medicine, Gulhane Military Medical Faculty, Ankara, Turkey
| |
Collapse
|
138
|
Hudzik B, Szkodziński J, Lekston A, Gierlotka M, Poloński L, Gąsior M. Mean platelet volume-to-lymphocyte ratio: a novel marker of poor short- and long-term prognosis in patients with diabetes mellitus and acute myocardial infarction. J Diabetes Complications 2016; 30:1097-102. [PMID: 27138871 DOI: 10.1016/j.jdiacomp.2016.04.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 04/11/2016] [Accepted: 04/12/2016] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Platelet activation and hyperreactivity plays a pivotal role in developing intravascular thrombus in ST elevation myocardial infarction (STEMI). Mean platelet volume (MPV), which is readily available in clinical settings, has been linked to poor prognosis following STEMI. Recently, platelet-to-lymphocyte ratio (PLR) has emerged as a new marker of worse outcomes linking inflammation and thrombosis. We investigated the prognostic significance of the new marker, MPVLR, in diabetic patients with STEMI undergoing percutaneous coronary intervention (PCI). METHODS A total of 623 patients with diabetes mellitus and STEMI undergoing primary PCI were enrolled and divided based on the median MPVLR on admission into two groups: group 1 (N=266) with an MPVLR ≤4.46 and group 2 (N=257) with an MPVLR >4,46. RESULTS Despite similar clinical features patients with elevated MPVLR (group 2) had worse angiographic characteristic suggestive of a higher thrombus burden. In-hospital and one-year mortality was higher in group 2. ROC analysis revealed moderate diagnostic value in predicting in-hospital mortality (adjusted HR 1.13; 95% CI 1.04-1.23; P=0.003; MPVLR cut-off >6.13) similar to that of PLR a good diagnostic value in predicting long-term mortality (adjusted HR 1.52; 95% CI 1.42-1.63; P<0.0001; MPVLR cut-off >5.88) better than that of PLR. MPVLR remained an independent risk factor of early and late mortality. CONCLUSIONS To the best of our knowledge, this is the first ever study that has investigated MPVLR. Despite similar clinical characteristics, patients with elevated MPVLR had worse angiographic features which may indicate a greater thrombus burden. Elevated MPVLR is an independent risk factor of early and late mortality following STEMI. In addition, it has similar value to PLR in predicting in-hospital mortality, and a better value than PLR in predicting long-term mortality.
Collapse
Affiliation(s)
- Bartosz Hudzik
- Third Department of Cardiology, Silesian Center for Heart Disease, SMDZ in Zabrze, Medical University of Silesia in Katowice.
| | - Janusz Szkodziński
- Third Department of Cardiology, Silesian Center for Heart Disease, SMDZ in Zabrze, Medical University of Silesia in Katowice
| | - Andrzej Lekston
- Third Department of Cardiology, Silesian Center for Heart Disease, SMDZ in Zabrze, Medical University of Silesia in Katowice
| | - Marek Gierlotka
- Third Department of Cardiology, Silesian Center for Heart Disease, SMDZ in Zabrze, Medical University of Silesia in Katowice
| | - Lech Poloński
- Third Department of Cardiology, Silesian Center for Heart Disease, SMDZ in Zabrze, Medical University of Silesia in Katowice
| | - Mariusz Gąsior
- Third Department of Cardiology, Silesian Center for Heart Disease, SMDZ in Zabrze, Medical University of Silesia in Katowice
| |
Collapse
|
139
|
Altintas O, Altintas MO, Tasal A, Kucukdagli OT, Asil T. The relationship of platelet-to-lymphocyte ratio with clinical outcome and final infarct core in acute ischemic stroke patients who have undergone endovascular therapy. Neurol Res 2016; 38:759-65. [PMID: 27477691 DOI: 10.1080/01616412.2016.1215030] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Of all strokes, 85% are ischemic and intracranial artery occlusion accounts for 80% of these ischemic strokes. Endovascular therapy for acute ischemic stroke was a new modality aiming at resolution of clots in occluded cerebral arteries. The platelet-to-lymphocyte ratio (PLR) was introduced as a potential marker to determine increased inflammation, which is a result of releasing many mediators from the platelets. In this study we aimed to evaluate whether the PLR had a prognostic role in stroke patients undergoing thrombectomy and attempted to determine the effect that this ratio had on their survival. METHODS Over a three-year period, demographic, clinical, and angiographic findings of 57 consecutive patients with acute ischemic stroke who underwent mechanical thrombectomy were evaluated. RESULTS The patients were divided into two groups on the basis of a PLR level cut-off value of 145 based on receiver operating characteristic (ROC) curve. Successful revascularization (mTICI 2b and 3) was achieved in 42 of 57 (73.7%) patients; a mTICI 3 state was observed in 21 of 23 patients with low-PLR values (p = .015). Patients with higher PLR values had significantly a score of less than six on the ASPECT scale compared to patients with lower PLR values (p = .005). The patients with low-PLR values had better functional outcomes (mRS ≤ 2) compared with the patients with high-PLR values [respectively, p = .004 (at first month) and p = .014 (at third month)]. DISCUSSION The platelet-to-lymphocyte ratio could represent pro-thrombotic inflammatory state in acute ischemic stroke patients because having a high-PLR values increased the poor prognosis, the rate of insufficient recanalization, and the size of infarcted area.
Collapse
Affiliation(s)
- Ozge Altintas
- a Nigde Bor State Hospital, Neurology Clinic , Nigde , Turkey
| | - Mehmet Ozgen Altintas
- b Faculty of Engineering, Department of Genetics and Bioengineering , Fatih University , Istanbul , Turkey
| | | | - Okkes Taha Kucukdagli
- d Bakirkoy Dr. Sadi Konuk Education and Training Hospital, Emergency Clinic , Istanbul , Turkey
| | - Talip Asil
- e Medical Faculty, Department of Neurology , Bezmi Alem Vakıf University , Istanbul , Turkey
| |
Collapse
|
140
|
Velibey Y, Oz A, Tanik O, Guvenc TS, Kalenderoglu K, Gumusdag A, Akdeniz E, Bozbay M, Tekkesin AI, Guzelburc O, Hayiroglu MI, Alper AT, Ugur M, Eren M. Platelet-to-Lymphocyte Ratio Predicts Contrast-Induced Acute Kidney Injury in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Angiology 2016; 68:419-427. [DOI: 10.1177/0003319716660244] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
We aimed to investigate the relationship between platelet-to-lymphocyte ratio (PLR) and contrast-induced acute kidney injury (CI-AKI) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). A total of 2563 patients diagnosed with STEMI and underwent primary pPCI were retrospectively included in the study. Levels of PLR and creatinine were measured before and at 72 hours after pPCI. Patients were divided into 2 groups: non-CI-AKI group and CI-AKI group. Contrast-induced acute kidney injury occurred in 6.4% of the overall study population. Patients in the CI-AKI group had significantly higher PLR than those in the non-CI-AKI group (169.18 ± 81.01 vs 149.49 ± 74.54, P < .001). In logistic regression analysis, PLR was an independent predictor of CI-AKI (odds ratio [OR]: 1.774, 95% CI: 1.243-2.532, P = .002), along with age, use of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker prior to the procedure, preprocedural creatinine level, amount of contrast material used during the procedure, and hypertension. Increased PLR levels are independently associated with a greater risk of CI-AKI in patients undergoing primary PCI for STEMI.
Collapse
Affiliation(s)
- Yalcin Velibey
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Oz
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Ozan Tanik
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Tolga Sinan Guvenc
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Koray Kalenderoglu
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Ayca Gumusdag
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Evliya Akdeniz
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Bozbay
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Ilker Tekkesin
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Ozge Guzelburc
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Mert Ilker Hayiroglu
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Taha Alper
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Murat Ugur
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Eren
- Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Istanbul, Turkey
| |
Collapse
|
141
|
Saskin H, Ozcan KS, Duzyol C, Baris O, Koçoğulları UC. Are inflammatory parameters predictors of amputation in acute arterial occlusions? Vascular 2016; 25:170-177. [DOI: 10.1177/1708538116652995] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background The aim of the present study was to investigate the role of inflammatory markers to predict amputation following embolectomy in acute arterial occlusion. Methods A total of 123 patients operated for arterial thromboembolectomy due to acute embolism were included in the study. The patients without an extremity amputation following thromboembolectomy were classified as Group 1 ( n = 91) and the rest were classified as Group 2 ( n = 32). These groups were compared in terms of clinical and demographic characteristics, C-reactive protein, complete blood count parameters, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and red cell distribution width. Results The average age was 68.0 ± 11.7 years. The most common thromboembolism localization was femoral artery. When preoperative mean C-reactive protein ( p = 0.0001), mean platelet volume ( p = 0.0001), platelet-lymphocyte ratio ( p = 0.0001), neutrophil-lymphocyte ratio ( p = 0.0001) and red cell distribution width ( p = 0.0001) were compared, a statistically significant difference was observed between groups. In univariate and multivariate regression analysis, higher levels of preoperative C-reactive protein ( p = 0.009) and mean platelet volume ( p = 0.04) were detected as independent risk factors of early extremity amputation. Conclusion We observed that preoperative mean platelet volume and C-reactive protein were predictors of amputation after thromboembolectomy in acute arterial occlusion.
Collapse
Affiliation(s)
- Huseyin Saskin
- Clinic of Cardiovascular Surgery, Derince Education and Research Hospital, Kocaeli, Turkey
| | - Kazim S Ozcan
- Clinic of Cardiology, Derince Education and Research Hospital, Kocaeli, Turkey
| | - Cagri Duzyol
- Clinic of Cardiovascular Surgery, Derince Education and Research Hospital, Kocaeli, Turkey
| | - Ozgur Baris
- Clinic of Cardiovascular Surgery, Derince Education and Research Hospital, Kocaeli, Turkey
| | - Uğur C Koçoğulları
- Clinic of Cardiovascular Surgery, Siyami Ersek Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey
| |
Collapse
|
142
|
Wu Y, Chen Y, Yang X, Chen L, Yang Y. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were associated with disease activity in patients with systemic lupus erythematosus. Int Immunopharmacol 2016; 36:94-99. [PMID: 27111516 DOI: 10.1016/j.intimp.2016.04.006] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Revised: 04/02/2016] [Accepted: 04/05/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have recently been investigated as two new inflammatory markers used in the assessment of systemic inflammation in many diseases. The purpose of the study was to investigate their relation with disease activity in newly diagnosed SLE patients. METHODS The study population consisted of 116 SLE patients who did not receive any treatment and 136 healthy controls. We divided the patients into two groups according to the SLE Disease Activity Index 2000 (SLEDAI-2K) system. Group 1 included patients with a score of 9 and lower (patients with mild disease activity), and Group 2 included patients with a score of >9 (patients with severe disease activity). Correlations between NLR, PLR and disease activity were analyzed. RESULTS The NLR and PLR of SLE patients were significantly higher compared to those of the controls (both P<0.001). There was a statistically significant difference in NLR and PLR between Group 1 and Group 2 (both P<0.05). SLEDAI scores positively correlated with NLR (r=0.312, P<0.001) and PLR (r=0.298, P<0.001). Furthermore, SLE patients with nephritis had higher NLR levels than those without nephritis (P=0.027). Based on the ROC curve, the best NLR cut-off value to predict SLE patients with severe disease activity was 2.26, with 75% sensitivity and 50% specificity, whereas the best PLR cut-off value was 203.85, with 42.3% sensitivity and 83.9% specificity. CONCLUSION NLR and PLR were two useful inflammatory markers for assessment of disease activity in patients with SLE.
Collapse
Affiliation(s)
- Yunxiu Wu
- Department of Endocrinology and Metabolism of the Second Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, China
| | - Yanjuan Chen
- Department of Endocrinology and Metabolism of the Second Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, China
| | - Xianming Yang
- Department of Internal Medicine, Ward of the Shantou Third People's Hospital, Shantou, Guangdong, China
| | - Lishu Chen
- Department of Endocrinology and Metabolism of the Second Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, China
| | - Yihua Yang
- Department of Endocrinology and Metabolism of the Second Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, China.
| |
Collapse
|
143
|
Hematological predictors and clinical outcomes in cardiac surgery. J Anesth 2016; 30:770-8. [DOI: 10.1007/s00540-016-2197-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 05/30/2016] [Indexed: 10/21/2022]
|
144
|
Çetin M, Kiziltunc E, Elalmış ÖU, Çetin ZG, Demirçelik MB, Çiçekçioğlu H, Kurtul A, Özkan S, Avan CM, Örnek E, Ulusoy FV. Predictive Value of Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio in Patients with Coronary Slow Flow. ACTA CARDIOLOGICA SINICA 2016; 32:307-12. [PMID: 27274171 DOI: 10.6515/acs20150119i] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Increased microvascular resistance due to chronic inflammation is assumed to be one of the mechanisms associated with coronary slow flow (CSF). Previous studies have shown that the platelet-to-lymphocyte ratio (PLR) and the neutrophil-lymphocyte ratio (NLR) are markers of inflammation for various diseases. In this study we aimed to evaluate the relationship between CSF and PLR-NLR. METHODS Seventy-eight patients with CSF and 50 patients with normal coronary flow were enrolled into this study. The study subjects underwent medical examination and testing, after which their platelet-to-lymphocyte ratios and NLR values were calculated. An independent observer measured the coronary flow rate by Thrombolysis in Myocardial Infarction Frame Count (TFC) method. The platelet-to-lymphocyte ratio and NLR values were compared between the groups and correlation analysis was performed to explore the relationship between mean TFC with PLR and NLR. RESULTS Platelet-to-lymphocyte ratio and NLR values were significantly higher in patients with CSF (p < 0.001). There was a positive significant correlation between TFC with NLR and PLR (Spearman's Rho: 0.59, p < 0.001 and Spearman's Rho: 0.30, p = 0.001, respectively). Multivariate logistic regression analysis revealed that NLR is the one independent predictor for CSF. CONCLUSIONS This study demonstrated an association between CSF and PLR-NLR. Although the exact mechanism could not be explained, our findings support the possible role of inflammation in CSF physiopathology.
Collapse
Affiliation(s)
- Mustafa Çetin
- Department of Cardiology, Ankara Numune Education and Research Hospital
| | | | | | - Zehra Güven Çetin
- Department of Cardiology, Ankara Numune Education and Research Hospital
| | | | - Hülya Çiçekçioğlu
- Department of Cardiology, Ankara Numune Education and Research Hospital
| | - Alparslan Kurtul
- Department of Cardiology, Ankara Education and Research Hospital
| | - Selçuk Özkan
- Department of Cardiology, Ankara Keçiören Education and Research Hospital
| | | | - Ender Örnek
- Department of Cardiology, Ankara Numune Education and Research Hospital
| | | |
Collapse
|
145
|
Çiçek G, Kundi H, Bozbay M, Yayla C, Uyarel H. The relationship between admission monocyte HDL-C ratio with short-term and long-term mortality among STEMI patients treated with successful primary PCI. Coron Artery Dis 2016; 27:176-84. [DOI: 10.1097/mca.0000000000000343] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
146
|
Relationship between platelet-to-lymphocyte ratio and the presence and severity of coronary artery ectasia. Anatol J Cardiol 2016; 16:857-862. [PMID: 27109243 PMCID: PMC5324888 DOI: 10.14744/anatoljcardiol.2015.6639] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective: The aim of this study was to investigate the relationship between platelet-to-lymphocyte ratio (PLR), an easily available inflammatory marker, and coronary artery ectasia (CAE). Methods: After applying the exclusion criteria, the retrospective study population consisted of 330 patients, including 110 patients with isolated CAE, 110 with obstructive coronary artery disease (CAD), and 110 with normal coronary artery angiograms (NCA). The severity of isolated CAE was determined according to the Markis classification. SPSS 22.0 statistical package program was used for data analysis. Results: PLR was significantly higher in patients with isolated CAE than in those with NCA and obstructive CAD [123 (113–156), 100 (86–138), and 110 (102–141), respectively]. Logistic regression analysis showed that PLR and C-reactive protein level were significantly correlated with the severity of isolated CAE. Conclusion: To the best of our knowledge, this study showed for the first time that PLR was significantly associated with CAE.
Collapse
|
147
|
The role of platelet-lymphocyte ratio in the severity of coronary artery disease assessed by the angiographic Gensini score. Anatol J Cardiol 2016; 16:224. [PMID: 27067570 PMCID: PMC5336822 DOI: 10.14744/anatoljcardiol.2016.6996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
148
|
Koseoglu HI, Altunkas F, Kanbay A, Doruk S, Etikan I, Demir O. Platelet-lymphocyte ratio is an independent predictor for cardiovascular disease in obstructive sleep apnea syndrome. J Thromb Thrombolysis 2016; 39:179-85. [PMID: 25002338 DOI: 10.1007/s11239-014-1103-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
There is a strong relationship between obstructive sleep apnea syndrome (OSAS) and cardiovascular disease (CVD). Chronic intermittent hypoxia, inflammation, oxidative stress, and endothelial dysfunction may constitute etiologic mechanisms, linking OSAS to CVD. Inflammation play an important role in the development of CVD. Platelet-lymphocyte ratio (PLR) is a new biomarker showing inflammation. No previous study has ever investigated the association between PLR, CVD and OSAS severity in patients with OSAS. This study was designed to investigate the association between PLR and CVD in patients with OSAS, and relationship between severity of OSAS, polysomnographic parameters and PLR. This was a cohort study in which patients who had undergone a full night polysomnoraphy for diagnosis of OSA were recruited. Patients were divided according to their apnea-hypopnea index (AHI) scores into OSAS negative (Group 1: AHI < 5), mild (Group 2: AHI, 5-15), moderate (Group 3:AHI,15-30), and severe OSAS (Group 4: AHI > 30) groups. The presence of heart failure, coronary artery disease or arrhythmia was defined as CVD. A total of 424 patients were included in this study. There were 57, 93, 82, and 192 patients in Groups 1, 2, 3, and 4, respectively. PLR were significantly different between groups (Group 1: 87.38; Group 2: 95.07; Group 3: 97.01, Group 4: 126.9, P < 0.05). PLR were significantly correlated with AHI, oxygen desaturation index, average and minimum O2 saturation values (P < 0.05). Values of PLR were significantly higher in patients with CVD compared with those without. Multiple regression analysis demonstrated that PLR is an independent predictor of CVD. PLR cut-off value for demonstrating the presence of CVD is higher than 108.56. In the light oh findings, PLR is strongly associated with the severity of OSAS and cardiovascular disease in OSAS patients. PLR might be used as a biomarker to predict CVD in OSAS patients.
Collapse
|
149
|
Yayla Ç, Açikgöz SK, Yayla KG, Açikgöz E, Canpolat U, Kirbaş Ö, Öksüz F, Özcan F, Akboğa MK, Topaloğlu S, Aras D. The association between platelet-to-lymphocyte ratio and inflammatory markers with the severity of aortic stenosis. Biomark Med 2016; 10:367-73. [PMID: 26974393 DOI: 10.2217/bmm-2015-0016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
AIM Platelet-to-lymphocyte ratio (PLR) was proposed as a novel indirect marker of inflammation. We aimed to evaluate the relationship between PLR and aortic stenosis (AS). PATIENTS & METHODS The study population included 453 patients of which 98 patients with severe AS, 206 patients with mild-to-moderate AS and 149 patients as control. RESULTS PLR was significantly increased in parallel to the severity of AS (p < 0.001). There was significant positive correlation between PLR and maximum, and mean systolic transaortic gradient (all p < 0.001). Also, PLR was correlated with C-reactive protein and neutrophil-to-lymphocyte ratio (all p < 0.001) and PLR was independently associated with the presence of AS (p < 0.001). CONCLUSION We found a significant relationship between PLR and AS.
Collapse
Affiliation(s)
- Çağrı Yayla
- Türkiye Yüksek Ihtisas Training & Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Sadık Kadri Açikgöz
- Türkiye Yüksek Ihtisas Training & Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Kadriye Gayretli Yayla
- Dışkapı Yıldırım Beyazıt Training & Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Eser Açikgöz
- Department of Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Uğur Canpolat
- Türkiye Yüksek Ihtisas Training & Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Özgür Kirbaş
- Türkiye Yüksek Ihtisas Training & Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Fatih Öksüz
- Türkiye Yüksek Ihtisas Training & Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Fırat Özcan
- Türkiye Yüksek Ihtisas Training & Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Mehmet Kadri Akboğa
- Türkiye Yüksek Ihtisas Training & Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Serkan Topaloğlu
- Türkiye Yüksek Ihtisas Training & Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Dursun Aras
- Türkiye Yüksek Ihtisas Training & Research Hospital, Cardiology Clinic, Ankara, Turkey
| |
Collapse
|
150
|
do Prado Junior PP, de Faria FR, de Faria ER, do Carmo Castro Franceschini S, Priore SE. Leukocytes as risk markers for cardiovascular disease in adolescents: association with birth characteristics, nutritional status and biochemical tests. REVISTA PAULISTA DE PEDIATRIA (ENGLISH EDITION) 2016. [PMID: 26572104 PMCID: PMC4795720 DOI: 10.1016/j.rppede.2015.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objective: To evaluate the correlation between the number of leukocytes and cardiovascular risks associated with birth characteristics, nutritional status and biochemical tests. Methods: Cross-sectional study developed with 475 adolescents, born between 1992 and 2001, in the municipality of Viçosa (MG). Maternal medical records were analyzed in the hospital units, and the following was recorded: birth weight and length, head circumference, chest circumference, Apgar score, gestational age. In adolescents, body mass index, skinfold thickness, body composition, blood count, biochemical tests and clinical variables were also assessed. The statistical analyses was carried out using Statistical Package for Social Sciences (SPSS) version 20.0 and Data Analysis and Statistical Software (STATA) with Kruskal–Wallis, Mann–Whitney, chi-square or Fisher's exact tests and Linear Regression. Significance level was set at α<0.05. The study was approved by the Research Ethics Committee of UFV for studies with human subjects. Results: Weight and birth length, head and chest circumference were higher among boys. In adolescents, the number of leukocytes was higher in individuals with excess weight and body fat and high adiposity index, waist-to-height ratio and waist circumference. Only altered triglycerides showed differences between leukocyte medians. Regardless of the anthropometric variable of the final regression model, the stage of adolescence, number of platelets, eosinophils, monocytes and lymphocytes were associated with the increase in leukocytes. Conclusions: The birth variables were not associated with changes in leukocyte numbers, whereas the anthropometric variables were good indicators for a higher leukocyte count, regardless of the stage of adolescence and gender.
Collapse
|