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Witarto AP, Rosyid AN, Witarto BS, Pramudito SL, Putra AJE. An in-depth investigation of serum Krebs von den Lungen-6 and other biomarkers in COVID-19 severity and mortality. Monaldi Arch Chest Dis 2024. [PMID: 39077858 DOI: 10.4081/monaldi.2024.2848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 06/03/2024] [Indexed: 07/31/2024] Open
Abstract
Krebs von den Lungen-6 (KL-6) is a glycoprotein mainly expressed by type II pneumocytes and recently known as a lung injury biomarker. However, the number of studies is still limited, especially in Indonesian COVID-19 populations. Therefore, we aim to provide correlation, sensitivity, and specificity analyses of KL-6 and other biomarkers in Indonesian COVID-19 severity and mortality. We conducted a cross-sectional study involving adult COVID-19 patients at Universitas Airlangga Hospital, Surabaya, East Java, Indonesia, between March 26, 2021, and August 25, 2021. KL-6 and other biomarker levels were compared according to severity (severe versus non-severe) and mortality (non-survivor versus survivor). We also included the receiver operating characteristic analysis to define the optimal cut-off, sensitivity, and specificity of KL-6 to determine COVID-19 severity and mortality. We enrolled 78 COVID- 19 patients (23 non-survivors), including 39 non-severe and 39 severe patients. There was no significant difference in serum KL-6 levels, neither in severity nor mortality groups. KL-6 had the strongest positive correlations with ferritin in severe patients (r=0.313) and non-survivors (r=0.467). We observed that the best sensitivity was KL-6 combined with platelet-to- lymphocyte ratio (PLR) (0.818) in severe patients and with neutrophil-to-lymphocyte ratio (NLR)/PLR/ferritin/C-reactive protein (0.867) in non-survivors. In contrast, the best specificity was found when KL-6 was combined with NLR/D-dimer (0.750) in severe patients and with D-dimer (0.889) in non-survivors. Serum KL-6 is a useful auxiliary laboratory evaluation index for COVID-19 lung injury to depict its severity and mortality.
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Affiliation(s)
| | - Alfian Nur Rosyid
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga Hospital, Universitas Airlangga, Surabaya.
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Vakhshoori M, Bondariyan N, Sabouhi S, Kiani K, Alaei Faradonbeh N, Emami SA, Shakarami M, Khanizadeh F, Sanaei S, Motamedi N, Shafie D. The impact of platelet-to-lymphocyte ratio on clinical outcomes in heart failure: a systematic review and meta-analysis. Ther Adv Cardiovasc Dis 2024; 18:17539447241227287. [PMID: 38305256 PMCID: PMC10838041 DOI: 10.1177/17539447241227287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Inflammation has been suggested to play a role in heart failure (HF) pathogenesis. However, the role of platelet-to-lymphocyte ratio (PLR), as a novel biomarker, to assess HF prognosis needs to be investigated. We sought to evaluate the impact of PLR on HF clinical outcomes. METHODS English-published records in PubMed/Medline, Scopus, and Web-of-science databases were screened until December 2023. Relevant articles evaluated PLR with clinical outcomes (including mortality, rehospitalization, HF worsening, and HF detection) were recruited, with PLR difference analysis based on death/survival status in total and HF with reduced ejection fraction (HFrEF) patients. RESULTS In total, 21 articles (n = 13,924) were selected. The total mean age was 70.36 ± 12.88 years (males: 61.72%). Mean PLR was 165.54 [95% confidence interval (CI): 154.69-176.38]. In total, 18 articles (n = 10,084) reported mortality [either follow-up (PLR: 162.55, 95% CI: 149.35-175.75) or in-hospital (PLR: 192.83, 95% CI: 150.06-235.61) death rate] and the mean PLR was 166.68 (95% CI: 154.87-178.50). Further analysis revealed PLR was significantly lower in survived HF patients rather than deceased group (152.34, 95% CI: 134.01-170.68 versus 194.73, 95% CI: 175.60-213.85, standard mean difference: -0.592, 95% CI: -0.857 to -0.326, p < 0.001). A similar trend was observed for HFrEF patients. PLR failed to show any association with mortality risk (hazard ratio: 1.02, 95% CI: 0.99-1.05, p = 0.289). Analysis of other aforementioned outcomes was not possible due to the presence of few studies of interest. CONCLUSION PLR should be used with caution for prognosis assessment in HF sufferers and other studies are necessary to explore the exact association.
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Affiliation(s)
- Mehrbod Vakhshoori
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Hezar Jarib Avenue, Isfahan, Iran
| | - Niloofar Bondariyan
- Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sadeq Sabouhi
- Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Keivan Kiani
- Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nazanin Alaei Faradonbeh
- Department of Emergency Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sayed Ali Emami
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrnaz Shakarami
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Shahin Sanaei
- Department of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Davood Shafie
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Esercan A, Demir İ. Predicting asphyxia in term fetus. J OBSTET GYNAECOL 2023; 43:2199064. [PMID: 37051710 DOI: 10.1080/01443615.2023.2199064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
This aim of this study was to investigate maternal hematological laboratory parameters of term infants before birth diagnosed with asphyxia compared to mothers of healthy term infants and predict asphyxia by these parameters. This study was conducted on 109 and 192 mothers of the fetus with asphyxia and healthy, respectively. Laboratory parameters of complete blood count, including PDW (platelet distribution width), PCT (procalcitonin) and NLR (neutrophil/lymphocyte ratio), were recorded before birth from pregnant women. PDW and basophil counts were significantly higher in the asphyxia group than healthy group (p: .000). The cut-off level of 19.425 accurately predicted the occurrence of asphyxia (AUC = 0.724 (95% confidence interval 0.65-0.78), p = .000). Basophil count could predict asphyxia, especially the cut-off level of> 0.15(10³/μL) (AUC = 0.67) (95% confidence interval 0.60-0.74, p = .000). To predict asphyxia before labor, a cheap and routine test of PDW can be used after more research in this area.IMPACT STATEMENTWhat is already known on this subject? Asphyxia is still an unsolved problem in neonatal mortality and morbidity, and it is seen in babies of mothers who carry some risks during pregnancy (such as multiple pregnancy, baby of mother with preeclampsia, meconium aspiration, diabetes); however, it is known that it is a subject that is still not fully understood as it can also occur as a result of labor that does not have any risk factors and goes well.What do the results of this study add? In term fetuses without risk factors, it can be predicted to a certain extent whether the fetus will be diagnosed with asphyxia from the hemogram test that can work from the blood of the mother before birth.What are the implications of these findings for clinical practice and/or further research? In clinical practice, asphyxia can be estimated with a cheap and simple test, without any extra examination, by looking at the routine blood tests taken from the mother before going into labor.
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Affiliation(s)
- Alev Esercan
- Obstetrics and Gynecology, Sanliurfa Education and Research Hospital, Sanliurfa, Turkey
| | - İsmail Demir
- Obstetrics and Gynecology, Sanliurfa Education and Research Hospital, Sanliurfa, Turkey
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The platelet to lymphocyte ratio in heart failure: a comprehensive review. ROMANIAN JOURNAL OF INTERNAL MEDICINE = REVUE ROUMAINE DE MEDECINE INTERNE 2023; 61:84-97. [PMID: 36801012 DOI: 10.2478/rjim-2023-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Indexed: 02/20/2023]
Abstract
Introduction. At the crossroads of heart failure (HF) and systemic inflammation, platelets and lymphocytes are both influenced as well as actively participating in the bidirectional relationship. The platelet to lymphocyte ratio (PLR) could therefore be a marker of severity. This review aimed to assess the role of PLR in HF. Methods. We searched the PubMed (MEDLINE) database using the keywords "platelet", "thrombocyte", "lymphocyte", "heart failure", "cardiomyopathy", "implantable cardioverter defibrillator", "cardiac resynchronization therapy" and "heart transplant". Results. We identified 320 records. 21 studies were included in this review, with a total of 17,060 patients. PLR was associated with age, HF severity, and comorbidity burden. Most studies reported the predictive power for all-cause mortality. Higher PLR was associated with in-hospital and short-term mortality in univariable analysis, however, it was not consistently an independent predictor for this outcome. PLR > 272.9 associated an adjusted HR of 3.22 (95%CI 1.56 - 5.68, p<0.001) for 30-day fatality. During long-term follow-up from 6 months to 5 years, PLR was an independent predictor of mortality in most studies, with cut-off values ranging from > 150 to > 194.97 and adjusted HR from 1.47 (95%CI 1.06 - 2.03, p=0.019) to 5.65 (95%CI 2.47-12.96, p<0.001). PLR > 173.09 had an adjusted OR 2.89 (95%CI 1.17-7.09, p=0.021) for predicting response to cardiac resynchronization therapy. PLR was not associated with outcomes after cardiac transplant or implantable cardioverter-defibrillator. Conclusion: Increased PLR could be an auxiliary biomarker of severity and survival prognosis in HF patients.
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Liu T, Wang B, Xiao S, Sun L, Zhu Z, Wang S, Li B, Yao J, Huang C, Ge W, Qian L, Lu Z, Pan Y. Correlation analysis between the static and the changed neutrophil-to-lymphocyte ratio and in-hospital mortality in critical patients with acute heart failure. Postgrad Med 2023; 135:50-57. [PMID: 36154549 DOI: 10.1080/00325481.2022.2129177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Association between neutrophil-to-lymphocyte ratio (NLR) on admission and poor prognosis in patients with acute heart failure (AHF) has been well established. However, the relationship between dynamic changes in NLR and in-hospital mortality in AHF patients has not been studied. Our purpose was to determine if an early change in NLR within the first week after AHF patients was admitted to intensive care unit (ICU) was associated with in-hospital mortality. METHODS Data from the medical information mart for intensive care IV (the MIMIC-IV) database was analyzed. The effect of baseline NLR on in-hospital mortality in critical patients with AHF was evaluated utilizing smooth curve fitting and multivariable logistic regression analysis. Moreover, comparison of the dynamic change in NLR among survivors and non-survivors was performed using the generalized additive mixed model (GAMM). RESULTS There were 1169 participants who took part in the present study, 986 of whom were in-hospital survivors and 183 of whom were in-hospital non-survivors. The smooth curve fitting revealed a positive relationship between baseline NLR and in-hospital mortality, and multivariable logistic regression analysis indicated that baseline NLR was an independent risk factor for in-hospital mortality (OR 1.04, 95% CI 1.02,1.07, P-value = 0.001). After adjusting for confounders, GAMM showed that the difference in NLR between survivors and non-survivors grew gradually during the first week after ICU admission, and the difference grew by an average of 0.51 per day (β = 0.51, 95% CI 0.45-0.56, P-value <0.001). CONCLUSIONS Baseline NLR was associated with poor prognosis in critical patients with AHF. Early rises in NLR were linked to higher in-hospital mortality, which suggests that keeping track of how NLR early changes might help identify short-term prognosis of critical patients with AHF.
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Affiliation(s)
- Tao Liu
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China
| | - Bing Wang
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China
| | - Shengjue Xiao
- Department of Cardiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Lifang Sun
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China
| | - Zhijian Zhu
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China
| | - Shasha Wang
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China
| | - Baoyin Li
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China
| | - Jianhui Yao
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China
| | - Conggang Huang
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China
| | - Wei Ge
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China
| | - Lei Qian
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China
| | - Zhigang Lu
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yesheng Pan
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, China
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Niu S, Pei Y, Hu X, Ding D, Jiang G. Relationship between the neutrophil-to-lymphocyte ratio or platelet-to-lymphocyte ratio and deep venous thrombosis (DVT) following femoral neck fractures in the elderly. Front Surg 2022; 9:1001432. [PMID: 36311921 PMCID: PMC9606705 DOI: 10.3389/fsurg.2022.1001432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 09/12/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose This study aimed to investigate whether the neutrophil-to-lymphocyte ratio (NLR) or platelet-to-lymphocyte ratio (PLR) was associated with deep venous thrombosis (DVT) following femoral neck fractures in the elderly. Method This was a retrospective cohort study and used data extracted from the hospitalization electronic medical record and the laboratory biomarker reports. Patients were included if they were aged above 60 years with a definite diagnosis of femoral neck fracture caused by low-energy trauma. Duplex ultrasound scanning was routinely performed to detect the potential DVT. Two independent multivariate logistic regression models were constructed to identify the association of NLR or PLR with the risk of DVT. Results A total of 708 patients with femoral neck fractures were included, and 112 were found to have DVT, indicating an incidence rate of 15.8%. There were significant differences across five subgroups for NLR or PLR, in terms of age (p = 0.020, 0.006), white blood cell (p < 0.001, =0.006), hemoglobin (p < 0.001, <0.001), and albumin (p < 0.001, <0.001). BMI was tested to be significantly different across subgroups for NLR (p = 0.030) and prevalence of cerebrovascular disease for PLR (p = 0.014). The multivariate analyses demonstrated that not NLR but PLR in Q3 (range, 179–238) was associated with an increased risk of DVT, and the risk for the latter was 1.86 (95%CI, 1.07–3.36). Conclusion We concluded that a PLR value of 179–238 was associated with a 1.86-fold increased risk of DVT after femoral neck fracture. This study paves the way toward further exploration of inflammatory/immune biomarkers with the risk of DVT in the elderly with trauma.
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Affiliation(s)
- Shuai Niu
- Department of Vascular Surgery, The General Hospital of Hebei Province, Shijiazhuang, China,Correspondence: Shuai Niu
| | - Yueying Pei
- Department of Doppler Ultrasonic, The General Hospital of Hebei Province, Shijiazhuang, China
| | - Xin Hu
- Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Dianzhu Ding
- Department of Vascular Surgery, The General Hospital of Hebei Province, Shijiazhuang, China
| | - Guangwei Jiang
- Department of Vascular Surgery, The General Hospital of Hebei Province, Shijiazhuang, China
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Türker Duyuler P, Duyuler S. Role of Beta Blockers in Inflammatory Response During Acute Heart Failure. Am J Cardiol 2022. [DOI: 10.1016/j.amjcard.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hayıroğlu Mİ, Çınar T, Çinier G, Pay L, Yumurtaş AÇ, Tezen O, Eren S, Kolak Z, Çetin T, Çiçek V, Tekkeşin Aİ. Evaluating systemic immune-inflammation index in patients with implantable cardioverter defibrillator for heart failure with reduced ejection fraction. Pacing Clin Electrophysiol 2022; 45:188-195. [PMID: 34978742 DOI: 10.1111/pace.14436] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/23/2021] [Accepted: 12/19/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pro-inflammatory pathways play an important role in the follow-ups of patients with intracardiac defibrillators (ICDs) for heart failure (HF) reduced with ejection fraction (HFrEF). A newly defined index - the systemic immune-inflammation index (SII)-has recently been reported to have prognostic value in patients with cardiovascular disease. This study's aim is to evaluate the SII value regarding its association with long-term mortality and appropriate ICD therapy during a 10-year follow-up. METHODS This retrospective study included 1011 patients with ICD for HFrEF. The SII was calculated as the neutrophil-to-lymphocyte ratio × total platelet count in the peripheral blood. The study population was divided into two groups according to the SII's optimal cut-off value to predict long-term mortality. The long-term prognostic impact of SII on these patients was evaluated regarding mortality and appropriate ICD therapy. RESULTS The patients with a higher SII (≥1119) had significantly higher long-term mortality and appropriate ICD therapy rates. After adjustment for all confounding factors, the long-term mortality rate was 5.1 for a higher SII. (95% CI: 2.9-8.1). The long-term appropriate ICD therapy rate was 2.0 for a higher SII (95% CI: 1.4-3.0). CONCLUSION SII may be an independent predictive marker for both long-term mortality and appropriate ICD therapy in patients with HFrEF.
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Affiliation(s)
- Mert İlker Hayıroğlu
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Tufan Çınar
- Department of Cardiology, Haydarpasa Sultan II. Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Göksel Çinier
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Levent Pay
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Çağdaş Yumurtaş
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ozan Tezen
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Semih Eren
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Zeynep Kolak
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Tuğba Çetin
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Vedat Çiçek
- Department of Cardiology, Haydarpasa Sultan II. Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Ahmet İlker Tekkeşin
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
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Li S, Qiu Y, Yu J, Shao M, Li Y, Cao W, Sun X. Association of systemic inflammation indices with visual field loss progression in patients with primary angle-closure glaucoma: potential biomarkers for 3P medical approaches. EPMA J 2021; 12:659-675. [PMID: 34745391 PMCID: PMC8561372 DOI: 10.1007/s13167-021-00260-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 10/17/2021] [Indexed: 12/18/2022]
Abstract
RELEVANCE Accumulating evidence suggests a dysfunction of the para-inflammation in the retinal ganglion cell layer and the optic nerve head in patients with glaucoma. Currently, circulating blood platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR) are regarded as novel indicators of systemic inflammation. Biomarkers allow early identification of patients with visual field (VF) loss progression and timely implementation of replacement therapies. OBJECTIVE This study aimed to investigate whether higher inflammatory indices (PLR, NLR, and LMR) were associated with VF loss progression in patients with primary angle-closure glaucoma (PACG) for the predictive diagnostics, targeted prevention, and personalization of medical services. METHODS This prospective cohort study followed up 277 patients with PACG for at least 24 months, with clinical examination and VF testing every 6 months. Inflammatory cell quantification, including platelets, neutrophils, lymphocytes, and monocytes, was measured using the Sysmex XN-A1 automated inflammatory cells quantification system. Three systemic inflammatory indices, PLR, NLR, and LMR, were determined on the basis of baseline neutrophil, lymphocyte, monocyte, and platelet counts in patients with PACG. The risk factors for PACG were analyzed using logistic regression, Cox proportional hazards regression, and the Kaplan-Meier curve. RESULTS Our results revealed that 111 (40.07%) patients showed VF loss progression. The PLR was significantly higher (P = 0.046) in the progression group than in the non-progression group. A higher PLR (OR 1.05, 95% CI 1.01-1.08, P = 0.004) was a risk factor for PACG progression. In multivariate analyses, PLR independently predicted VF loss progression (HR 1.01, 95% CI 1.00-1.01, P = 0.04). Kaplan-Meier curve analysis showed that higher PLR indicated significantly higher rates of VF loss progression (66.91% vs. 52.90%, P = 0.03). Comparable results were observed in the male and female subgroups. CONCLUSION Our findings revealed the significant association between a high PLR and a greater risk of VF loss progression in patients with PACG. PLR may be highly recommended as a novel predictive/diagnostic tool for the assessment of VF loss progression from the perspectives of predictive, preventive, and personalized medicine in vulnerable populations and for individual screening. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s13167-021-00260-3.
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Affiliation(s)
- Shengjie Li
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
| | - Yichao Qiu
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jian Yu
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Mingxi Shao
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yingzhu Li
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wenjun Cao
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
| | - Xinghuai Sun
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
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Heidarpour M, Bashiri S, Vakhshoori M, Heshmat-Ghahdarijani K, Khanizadeh F, Ferdowsian S, Shafie D. The association between platelet-to-lymphocyte ratio with mortality among patients suffering from acute decompensated heart failure. BMC Cardiovasc Disord 2021; 21:454. [PMID: 34537010 PMCID: PMC8449504 DOI: 10.1186/s12872-021-02260-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 09/13/2021] [Indexed: 02/08/2023] Open
Abstract
Background Platelet-to-lymphocyte ratio (PLR) is an inflammation index suggested to have the prognostic capability in heart failure (HF). We sought to investigate the association of PLR with cardiovascular disease (CVD) mortality and creatinine (Cr) rise among Iranian individuals suffering from acute decompensated HF (ADHF). Methods This retrospective cohort study was in the context of the Persian Registry Of cardioVascular diseasE/Heart Failure (PROVE/HF) study. 405 individuals with ADHF admitted to the emergency department were recruited from April 2019 to March 2020. PLR was calculated by division of platelet to absolute lymphocyte counts and categorized based on quartiles. We utilized the Kaplan–Meier curve to show the difference in mortality based on PLR quartiles. Cr rise was defined as the increment of at least 0.3 mg/dl from baseline. Cox proportional hazard ratio (HR) was used to investigate the association of PLR with CVDs mortality. Results Mean age of participants was 65.9 ± 13.49 years (males: 67.7%). The mean follow-up duration was 4.26 ± 2.2 months. CVDs mortality or re-hospitalization was not significantly associated with PLR status. Multivariate analysis of PLR quartiles showed a minimally reduced likelihood of CVDs death in 2nd quartile versus the first one (HR 0.40, 95% confidence interval (CI) 0.16–1.01, P = 0.054). Cr rise had no remarkable relation with PLR status in neither model. Conclusion PLR could not be used as an independent prognostic factor among ADHF patients. Several studies are required clarifying the exact utility of this index.
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Affiliation(s)
- Maryam Heidarpour
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sepideh Bashiri
- Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrbod Vakhshoori
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kiyan Heshmat-Ghahdarijani
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Shaghayegh Ferdowsian
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Davood Shafie
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
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Meng Z, Yang J, Wu J, Zheng X, Zhao Y, He Y. Association between the platelet-lymphocyte ratio and short-term mortality in patients with non-ST-segment elevation myocardial infarction. Clin Cardiol 2021; 44:994-1001. [PMID: 34037246 PMCID: PMC8259151 DOI: 10.1002/clc.23648] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 05/01/2021] [Accepted: 05/12/2021] [Indexed: 12/26/2022] Open
Abstract
Background Previous studies have shown that inflammation plays an important role in atherosclerosis and cardiovascular disease. Platelet to lymphocyte ratio (PLR) has been reported as a novel inflammatory marker. However, it is not clear whether PLR is associated with short‐term all‐cause mortality in critically ill patients with non‐ST‐segment elevation myocardial infarction (NSTEMI). Methods The data for the study is from the Medical Information Mart for Intensive Care III database. The primary outcome in our study was 28‐day mortality. Kapan‐Meier curve, lowess smoother curve, and multivariate Cox regression models were used to determine whether the association between PLR and 28‐day mortality of critically ill patients with NSTEMI. Results A total of 1273 critically ill patients with NSTEMI were included in this analysis. Kapan‐Meier curve and lowess smoother curve show that high PLR is associated with an increased risk of 28‐day all‐cause mortality. The study population is divided into two groups according to the cut‐off value of PLR level. In the Cox model, high PLR levels (PLR≥195.8) were significantly associated with increased 28‐day mortality (HR 1.54; 95%CI 1.09–2.18, p = .013). In quartile analyses, the HR (95% CI) for the third (183 ≤ PLR < 306) and fourth quartile (PLR≥306) was 1.55 (1.05–2.29) and 1.61 (1.03–2.52), respectively, compared to the reference group(111 ≤ PLR < 183). In subgroup analyses, there is no interaction effect in most of the subgroups except for respiratory failure and vasopressor use. Conclusion High PLR is associated with an increased risk of short‐term mortality in critically ill patients with NSTEMI.
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Affiliation(s)
- Zhongyuan Meng
- Clinical Medical College, Guangxi Medical University, Nanning, Guangxi, China
| | - Jiaqiang Yang
- Clinical Medical College, Guangxi Medical University, Nanning, Guangxi, China
| | - Jianfu Wu
- Clinical Medical College, Guangxi Medical University, Nanning, Guangxi, China
| | - Xifeng Zheng
- Clinical Medical College, Guangxi Medical University, Nanning, Guangxi, China
| | - Yaxin Zhao
- Clinical Medical College, Guangxi Medical University, Nanning, Guangxi, China
| | - Yan He
- Division of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Delcea C, Buzea CA, Vijan A, Draghici A, Stoichitoiu LE, Dan GA. Comparative role of hematological indices for the assessment of in-hospital outcome of heart failure patients. SCAND CARDIOVASC J 2021; 55:227-236. [PMID: 33761824 DOI: 10.1080/14017431.2021.1900595] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background. The mutual relation between heart failure (HF) and inflammation is reflected in blood cell homeostasis. Neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR) and platelet-lymphocyte ratio (PLR) were linked to HF severity and prognosis. Aims. Our objective was to compare the three ratios for predicting in-hospital outcome of HF patients, in order to establish which is best suited for clinical practice. Methods. Consecutive HF patients admitted to a Cardiology Department from a tertiary hospital were retrospectively evaluated for inclusion. Readmissions and pathologies modifying the hematological indices were excluded. Extended length of hospital stay (LOS) was considered over 7 d. In-hospital all-cause mortality was evaluated. Results: The hematological indices in heart failure (HI-HF) cohort included 1299 patients with a mean age of 72.35 ± 10.45 years, 51.96% women. 2.85% died during hospitalization. 22.17% had extended LOS. In Cox regression for in-hospital mortality alongside parameters from the OPTIMIZE-HF proposed model, all three ratios were independent predictors of mortality. In Cox regression including NT-proBNP, dyspnea at rest, chronic obstructive pulmonary disease (COPD), age and systolic blood pressure, only MLR was an independent predictor of in-hospital mortality (HR 1.68, 95% CI 1.22 - 2.32, p = .002). In multivariable logistic regression, all three ratios independently predicted extended LOS. MLR > 0.48 associated the highest probability (OR 1.76, 95% CI 1.25 - 2.46, p = .001). Conclusions. Hematological indices could be cost-effective and easily available auxiliary biomarkers for in-hospital prognosis of HF patients. We propose MLR > 0.48 as the strongest predictor of in-hospital mortality and prolonged hospitalization.
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Affiliation(s)
- Caterina Delcea
- Internal Medicine Department "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Cardiology Department, Colentina University Hospital, Bucharest, Romania
| | - Catalin Adrian Buzea
- Internal Medicine Department "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Cardiology Department, Colentina University Hospital, Bucharest, Romania
| | - Ancuta Vijan
- Internal Medicine Department "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Cardiology Department, Colentina University Hospital, Bucharest, Romania
| | - Anamaria Draghici
- Internal Medicine Department "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Internal Medicine Department, Colentina University Hospital, Bucharest, Romania
| | | | - Gheorghe-Andrei Dan
- Internal Medicine Department "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Cardiology Department, Colentina University Hospital, Bucharest, Romania
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Is there an association between platelet and blood inflammatory indices and the risk of gestational diabetes mellitus? Obstet Gynecol Sci 2020; 63:133-140. [PMID: 32206652 PMCID: PMC7073359 DOI: 10.5468/ogs.2020.63.2.133] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/17/2019] [Accepted: 10/28/2019] [Indexed: 12/14/2022] Open
Abstract
Objective Gestational diabetes mellitus (GDM) is the most prevalent medical complication in pregnancy. Early diagnosis of GDM can influence maternal/neonatal outcomes. To assess the association between platelet and blood inflammatory indices and the risk of GDM occurrence using the complete blood count (CBC) test. We also aimed to determine the sensitivity of each parameter for an early screening of this disorder during pregnancy. Methods This case-control study included 2 groups of 110 pregnant women with and without GDM. The women in each group were compared after the routine screening for GDM and after the CBC test at 24–28 weeks' gestation after being matched according to the inclusion criteria. Data were analyzed using SPSS version 16 and Medcalc version 14.8.1 software. Results There were statistically significant intergroup differences in white blood cell (WBC) count, platelet count, mean platelet volume (MPV), plateletcrit (PCT), MPV to platelet ratio, platelet to lymphocyte ratio, and Rh values. The values of lymphocyte count, neutrophil count, neutrophil to lymphocyte ratio, and blood group were not significantly different between groups. The logistic regression analysis showed the predictive values of WBC, platelet, MPV, and PCT in GDM. According to the receiver operating characteristic curve for all 3 variables, the level below the PCT chart was more than that of the others. Conclusion Increasing platelet and inflammatory indices on the CBC test in the second trimester of pregnancy seemed to be associated with the probability of GDM occurrence.
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