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Ul Hussain H, Kumar KA, Zahid M, Husban Burney M, Khan Z, Asif M, Rehan ST, Ahmad Cheema H, Swed S, Yasmin F, Ullah W, Alraies MC. Neutrophil to lymphocyte ratio as a prognostic marker for cardiovascular outcomes in patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e38692. [PMID: 38941418 DOI: 10.1097/md.0000000000038692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Neutrophil to lymphocyte ratio (NLR) has been considered a prognostic biomarker of mortality and other major cardiac events. This study investigates NLR's efficacy in predicting in-hospital and long-term outcomes in patients with ST-segment elevated myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). METHODS Electronic databases (PUBMED, Cochrane CENTRAL, ERIC, Embase, Ovid, and Google Scholar) were searched till June 2022 to identify studies having STEMI patients who underwent PCI. Risk ratios and mean differences (MDs), along with their corresponding 95% confidence intervals (Cis) and standard deviations (SDs), were pooled using a random-effect model. This meta-analysis has been registered on Prospero (ID: CRD42022344072). RESULTS A total of 35 studies with 28,756 patients were included. Pooled estimates revealed an increased incidence of primary outcomes; in-hospital all-cause mortality (RR = 3.52; 95% CI = 2.93-4.24), long-term all-cause mortality (HR = 1.07; 95% CI = 1.00-1.14), (RR = 3.32; 95% CI = 2.57-4.30); in-hospital cardiovascular mortality (RR = 2.66; 95% CI = 2.04-3.48), long-term cardiovascular mortality (RR = 6.67; 95% CI = 4.06-10.95); in-hospital major adverse cardiovascular events (MACE) (RR = 1.31; 95% CI = 1.17-1.46), long-term MACE (RR = 2.92; 95% CI = 2.16-3.94); length of hospital stay (WMD = 0.60 days; 95% CI = 0.40-0.79) in patients with high NLR compared to those with a low NLR. CONCLUSION NLR might be a valuable tool for prognostication (in-hospital) and stratification of patients with STEMI who underwent PCI.
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Affiliation(s)
| | | | - Marium Zahid
- Karachi Medical and Dental College, Karachi, Pakistan
| | | | - Zayeema Khan
- Dow University of Health Sciences, Karachi, Pakistan
| | - Muqaddus Asif
- Dow University of Health Sciences, Karachi, Pakistan
| | | | | | - Sarya Swed
- Aleppo University Faculty of Medicine, Aleppo, Syria
| | - Farah Yasmin
- Dow University of Health Sciences, Karachi, Pakistan
| | - Waqas Ullah
- Thomas Jefferson University Hospitals, Philadelphia, PA
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Cheng Y, Chen Y, Mao M, Wang R, Zhu J, He Q. Association of inflammatory indicators with intensive care unit mortality in critically ill patients with coronary heart disease. Front Immunol 2023; 14:1295377. [PMID: 38035097 PMCID: PMC10682191 DOI: 10.3389/fimmu.2023.1295377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Objective Coronary heart disease (CHD) is one of the major cardiovascular diseases, a common chronic disease in the elderly and a major cause of disability and death in the world. Currently, intensive care unit (ICU) patients have a high probability of concomitant coronary artery disease, and the mortality of this category of patients in the ICU is receiving increasing attention. Therefore, the aim of this study was to verify whether the composite inflammatory indicators are significantly associated with ICU mortality in ICU patients with CHD and to develop a simple personalized prediction model. Method 7115 patients from the Multi-Parameter Intelligent Monitoring in Intensive Care Database IV were randomly assigned to the training cohort (n = 5692) and internal validation cohort (n = 1423), and 701 patients from the eICU Collaborative Research Database served as the external validation cohort. The association between various inflammatory indicators and ICU mortality was determined by multivariate Logistic regression analysis and Cox proportional hazards model. Subsequently, a novel predictive model for mortality in ICU patients with CHD was developed in the training cohort and performance was evaluated in the internal and external validation cohorts. Results Various inflammatory indicators were demonstrated to be significantly associated with ICU mortality, 30-day ICU mortality, and 90-day ICU mortality in ICU patients with CHD by Logistic regression analysis and Cox proportional hazards model. The area under the curve of the novel predictive model for ICU mortality in ICU patients with CHD was 0.885 for the internal validation cohort and 0.726 for the external validation cohort. The calibration curve showed that the predicted probabilities of the model matched the actual observed probabilities. Furthermore, the decision curve analysis showed that the novel prediction model had a high net clinical benefit. Conclusion In ICU patients with CHD, various inflammatory indicators were independent risk factors for ICU mortality. We constructed a novel predictive model of ICU mortality risk in ICU patients with CHD that had great potential to guide clinical decision-making.
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Affiliation(s)
- Yuan Cheng
- Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Yang Chen
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
| | - Mengxia Mao
- The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China
| | - Ruixuan Wang
- School of Electronics and Computer Science, University of Liverpool, Liverpool, United Kingdom
| | - Jun Zhu
- School of Civil Engineering, Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Qing He
- Key Laboratory of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu, Sichuan, China
- Department of Intensive Care Medicine, Affiliated Hospital of Southwest Jiaotong University/The Third People’s Hospital of Chengdu, Chengdu, Sichuan, China
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Yuan T, Aisan A, Maheshati T, Tian R, Li Y, Chen Y. Predictive value of combining leucocyte and platelet counts for mortality in ST-segment elevation myocardial infarction patients after percutaneous coronary intervention treatment in Chinese population: a retrospective cohort study. BMJ Open 2023; 13:e060756. [PMID: 37463806 PMCID: PMC10357638 DOI: 10.1136/bmjopen-2022-060756] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 06/28/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVE Risk stratification is challenging in patients with acute ST segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI). We investigated the prognostic value of a novel score system combining leucocyte and platelet counts (COL-P) scores for in-hospital and long-term adverse outcomes. DESIGN This was a retrospective cohort study of patients with STEMI. SETTING First Affiliated Hospital of Xinjiang Medical University. PARTICIPANTS A total of 854 STEMI patients with primary PCI were included in this study from November 2009 and December 2015. PRIMARY AND SECONDARY OUTCOME MEASURES Major adverse cardiovascular events (MACEs). METHODOLOGY The patients were divided into three groups according to the COL-P scores (0, 1 and 2). Cox regression analysis was used to investigate the relation between adverse outcomes and the COL-P score in patients with STEMI. RESULTS A total of 44 patients died in hospital, and 99 within 3-year follow-up after discharge. The in-hospital and 3-year mortality and MACEs were higher in patients with higher COL-P score. Multivariable Cox regression indicated COL-P score was independently associated with long-term mortality (COL-P 1 vs COL-P 0: HR 2.07, 95% CI 1.016 to 5.567, p=0.005; COL-P 2 vs COL-P 0: HR 5.02, 95% CI 1.990 to 9.041, p<0.001). CONCLUSION The COL-P score was a useful risk system for stratifying high-risk patients with STEMI after primary PCI.
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Affiliation(s)
- Teng Yuan
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Aikebai Aisan
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Tunike Maheshati
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Ren Tian
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yunxia Li
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - You Chen
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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Tzikos G, Alexiou I, Tsagkaropoulos S, Menni AE, Chatziantoniou G, Doutsini S, Papavramidis T, Grosomanidis V, Stavrou G, Kotzampassi K. Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio as Predictive Factors for Mortality and Length of Hospital Stay after Cardiac Surgery. J Pers Med 2023; 13:jpm13030473. [PMID: 36983655 PMCID: PMC10054765 DOI: 10.3390/jpm13030473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/18/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
Background: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are widely accepted indices positively correlated with disease severity, progression, and mortality. In this study, we tested whether NLR and PLR could predict mortality and length of hospital stay (LOS) after cardiac surgery. Methods: NLR and PLR were calculated on days 0, 3, 5, and 7 postoperatively. A ROC curve was generated to assess their prognostic value; multivariate logistic analysis identified independent risk factors for 90-day mortality. Results: Analysis was performed on 179 patients’ data, 11 of whom (6.15%) died within 90 days. The discriminatory performance for predicting 90-day mortality was better for NLR7 (AUC = 0.925, 95% CI:0.865–0.984) with the optimal cut-off point being 7.10. NLR5 and PLR3 also exhibited a significant strong discriminative performance. Similarly, a significant discriminative performance was prominent for PLR3, NLR5, and NLR7 with respect to LOS. Moreover, NLR7 (OR: 2.143, 95% CI: 1.076–4.267, p = 0.030) and ICU LOS (OR:1.361, 95% CI: 1.045–1.774, p = 0.022) were significant independent risk factors for 90-day mortality. Conclusions: NLR and PLR are efficient predictive factors for 90-day mortality and LOS in cardiac surgery patients. Owing to the simplicity of determining NLR and PLR, their postoperative monitoring may offer a reliable predictor of patients’ outcomes in terms of LOS and mortality.
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Affiliation(s)
- Georgios Tzikos
- Department of Surgery, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
- Correspondence:
| | - Ioannis Alexiou
- Department of Cardiothoracic Surgery, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | - Sokratis Tsagkaropoulos
- Department of Cardiothoracic Surgery, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | | | | | - Soultana Doutsini
- Department of Surgery, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | | | - Vasilios Grosomanidis
- Department of Surgery, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | - George Stavrou
- Department of Surgery, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
| | - Katerina Kotzampassi
- Department of Surgery, Aristotle University of Thessaloniki, 546 36 Thessaloniki, Greece
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Sun R, Huang F, Wu W, Yin G, Ding Q, Gu Z, Fan C, Song C, Liang M, Liu X, Bi X. Association of neutrophil to lymphocyte ratio and D-dimer with functional outcome in patients with cerebral venous sinus thrombosis. BMC Neurol 2023; 23:30. [PMID: 36658518 PMCID: PMC9850605 DOI: 10.1186/s12883-022-03030-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 12/15/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Investigations on the risk factors for the prognosis of cerebral venous sinus thrombosis (CVST) are limited. This study aimed to explore whether specific inflammatory factors and coagulation indictors are associated with functional outcome in patients treated for CVST. METHODS This retrospective study included 137 patients admitted to our hospital between January 2010 and October 2021. The functional outcome was assessed with the modified Rankin Scale (mRS) score at discharge. Patients were divided into two groups, 102 patients with favorable outcomes (mRS 0-1) and 35 patients with poor outcomes (mRS 2-6). The clinical indexes were compared between two groups. Multivariable logistic regression was performed to identify the independent influencing factors for poor outcomes of CVST patients. The prognostic indicators were analyzed using the receiver operating characteristic (ROC) curve. RESULTS Compared with the favorable outcome group, the incidence of impaired consciousness and brain lesion, the levels of D-dimer, RDW, neutrophil count, neutrophil to lymphocyte ratio (NLR) and red blood cell distribution width to platelet ratio (%) on admission were significantly higher in the poor outcome group, while the level of lymphocyte count was significantly lower. After multivariable logistic regression analysis, baseline D-dimer level (odds ratio (OR), 1.180; 95% confidence interval (CI), 1.019-1.366, P = 0.027) and NLR (OR, 1.903; 95%CI, 1.232-2.938, P = 0.004) were significantly associated with unfavorable outcome at discharge. The ROC curve analysis showed that the areas under the curve of D-dimer, NLR and their combined detection for predicting worse outcome were 0.719, 0.707 and 0.786, respectively. CONCLUSIONS Elevated D-dimer level and NLR on admission were associated with an increased risk of poor functional outcome in patients with CVST.
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Affiliation(s)
- Rui Sun
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
| | - Feihong Huang
- Department of Neurology, Guilin People’s Hospital, Guilin, 541000 China
| | - Wen Wu
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
| | - Ge Yin
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
| | - Qichao Ding
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
| | - Zhengsheng Gu
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
| | - Cunxiu Fan
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
| | - Chenrui Song
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
| | - Meng Liang
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
| | - Xiaobei Liu
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
| | - Xiaoying Bi
- grid.73113.370000 0004 0369 1660Department of Neurology, Shanghai Changhai Hospital, Second Military Medical University/Naval Medical University, Shanghai, 200433 China
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Lin Y, Dai W, Chen Y, He X, Xu Y. Neutrophil-to-platelet ratio predicts mortality following percutaneous coronary intervention in patients with acute ST-elevation myocardial infarction. Front Physiol 2022; 13:1011048. [PMID: 36200052 PMCID: PMC9527305 DOI: 10.3389/fphys.2022.1011048] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 08/22/2022] [Indexed: 11/23/2022] Open
Abstract
This study aimed to evaluate the value of neutrophil-to-platelet ratio (NPR) in predicting all-cause mortality in patients with ST-elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI). We enrolled 186 patients with STEMI who underwent primary PCI in the Third Affiliated Hospital of Guangzhou Medical University between January 2017 and December 2018. Based on the NPR values, the patients were divided into two groups: the NPR >0.035 group (n = 82) and the NPR ≤0.035 group (n = 104). All-cause mortality of the patients was followed up for 3 years. By the end of 3 years, 109 (58.6%) patients survived, 53 (28.5%) died, and 24 (12.9%) were lost to follow-up. Univariate analyses found that NPR was associated with all-cause mortality (p < 0.05). In COX regression analyses, patients in the high NPR group had a higher risk of all-cause death than those in the low NPR group (HR = 2.296, 95% CI: 1.150–4.582). These results indicate that NPR could predict all-cause death in 3 years after primary PCI in patients STEMI. NPR values may be useful in risk stratification and in specifying individualized treatment in patients with STEMI. In addition, NPR is a low-cost and easily accessible indicator, if its strong predictive value is confirmed in further studies of other large populations, it can be introduced into clinical practice for effective application.
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Affiliation(s)
| | | | | | | | - Yunhong Xu
- *Correspondence: Xiaoqing He, ; Yunhong Xu,
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7
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Tang Y, Chen L, Li B, Yang L, Ouyang W, Li D. Preoperative Neutrophil-Lymphocyte Ratio for predicting surgery-related acute kidney injury in non-cardiac surgery patients under general anaesthesia: A retrospective cohort study. PLoS One 2022; 17:e0270066. [PMID: 35905108 PMCID: PMC9337669 DOI: 10.1371/journal.pone.0270066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 06/03/2022] [Indexed: 11/28/2022] Open
Abstract
Background This study was conducted to investigate the relationship between the Neutrophil-Lymphocyte Ratio (NLR) and the incidence of surgery-related acute kidney injury (AKI) in non-cardiac surgery patients under general anaesthesia. Methods In this retrospective study, 5057 patients from Third Xiangya hospital from January 2012 to December 2016 and 1686 patients from Second Xiangya hospital from January 2016 to December 2016 for non-cardiac surgery under general anesthesia were included. According to receiver operating characteristic (ROC) curve constructed by NLR for postoperative AKI, the cut-off point was obtained as the basis for grouping low or high NLR. The baseline characteristics of two sets were compared with each other. A multi-factor model was constructed by Least absolute shrinkage and selection operator (LASSO) method with the training set, and verified by outside validation set. Results 243 patients (3.604%) developed postoperative AKI. The ROC curve showed that the AUC of the NLR for predicting postoperative AKI in non-cardiac surgery was 0.743 (95% CI, 0.717–0.769), and the cut-off value was 3.555 (sensitivity, 86.4%; specificity 51.9%). There was no significant difference in the baseline characteristics of training set and validation set. The AUC in the training set was 0.817 (95% CI, 0.784–0.850), and the AUC in the validation set was 0.804 (95% CI, 0.749–0.858), the AUC deviation was 0.012 (P > 0.05) from validation set, and the likelihood ratio test showed P < 0.05. Conclusion This study showed that preoperative high NLR (NLR≥3.555) was an independent risk factor associated with postoperative AKI (OR, 2.410; 95% CI, 1.371–4.335) in patients for non-cardiac surgery under general anesthesia.
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Affiliation(s)
- Yongzhong Tang
- Department of Anesthesiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Linchong Chen
- Department of Anesthesiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Bo Li
- Operation Room, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Lin Yang
- Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Wen Ouyang
- Department of Anesthesiology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Dan Li
- Department of Anesthesiology, The Third Xiangya Hospital, Central South University, Changsha, China
- * E-mail:
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Zhao Y, Hao C, Bo X, Lu Z, Qian H, Chen L. The prognostic value of admission lymphocyte-to-monocyte ratio in critically ill patients with acute myocardial infarction. BMC Cardiovasc Disord 2022; 22:308. [PMID: 35799102 PMCID: PMC9264617 DOI: 10.1186/s12872-022-02745-z] [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: 03/23/2022] [Accepted: 06/30/2022] [Indexed: 11/11/2022] Open
Abstract
Background Inflammation plays a critical role in acute myocardial infarction (AMI). Recent studies have shown the value of hematologic indicators in MI risk stratification and prognostic assessment. However, the association between lymphocyte-to-monocyte ratio (LMR) and the long-term mortality of critically ill MI patients remains unclear. Methods Clinical data were extracted from the Medical Information Mart for Intensive Care III database. Patients diagnosed with AMI on admission in the intensive care units were include. The optimal cutoff value of LMR was determined by X-tile software. The Cox proportional hazard model was applied for the identification of independent prognostic factors of 1-year mortality and survival curves were estimated using the Kaplan–Meier method. In order to reduce selection bias, a 1:1 propensity score matching (PSM) method was performed. Results A total of 1517 AMI patients were included in this study. The cutoff value for 1-year mortality of LMR determined by X-Tile software was 3.00. A total of 534 pairs of patients were matched after PSM. Multivariate analysis (HR = 1.369, 95%CI 1.110–1.687, P = 0.003) and PSM subgroups (HR = 1.299, 95%CI 1.032–1.634, P = 0.026) showed that 1-year mortality was significantly higher in patients with LMR < 3.00 than patients with LMR ≥ 3.00 in Cox proportional hazard models. The survival curves showed that patients with LMR < 3.00 had a significantly lower 1-year survival rate before (63.83 vs. 81.03%, Log rank P < 0.001) and after PSM (68.13 vs. 74.22%, Log rank P = 0.041). Conclusion In this retrospective cohort analysis, we demonstrated that a low admission LMR (< 3.00) was associated with a higher risk of 1-year mortality in critically ill patients with AMI. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02745-z.
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Affiliation(s)
- Yuanyuan Zhao
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China
| | - Chunshu Hao
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China
| | - Xiangwei Bo
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China
| | - Zhengri Lu
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China
| | - Hao Qian
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China.,School of Medicine, Southeast University, Nanjing, China
| | - Lijuan Chen
- Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China. .,School of Medicine, Southeast University, Nanjing, China. .,Department of Cardiology, Nanjing Lishui People's Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, China.
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Gur DO, Efe MM, Alpsoy S, Akyüz A, Uslu N, Çelikkol A, Gur O. Índice Imunoinflamatório Sistêmico como Determinante de Carga Aterosclerótica e Pacientes de Alto Risco com Síndromes Coronarianas Agudas. Arq Bras Cardiol 2022; 119:382-390. [PMID: 35766615 PMCID: PMC9438541 DOI: 10.36660/abc.20210416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 01/26/2022] [Indexed: 11/18/2022] Open
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Systemic immune-inflammation index predicts in-hospital and long-term outcomes in patients with ST-segment elevation myocardial infarction. Coron Artery Dis 2022; 33:251-260. [PMID: 35044330 DOI: 10.1097/mca.0000000000001117] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study examines the predictive value of the novel systemic immune-inflammation index (SII) in patients with ST-segment elevation myocardial infarction (STEMI). METHODS A total of 1660 patients with STEMI who underwent primary percutaneous coronary intervention (pPCI) were enrolled in the study. In-hospital and 3-year outcomes were compared between the four groups (Q1-4). The SII was calculated using the following formula: neutrophil*platelet/lymphocyte. RESULTS The frequency of in-hospital cardiogenic shock, acute respiratory failure, acute kidney injury, ventricular arrhythmia, stent thrombosis, recurrent myocardial infarction, major adverse cardiac events and mortality were significantly higher in the high SII groups (Q3 and Q4). Logistic regression models demonstrated that Q3 and Q4 had an independent risk of mortality and Q4 had an independent risk of cardiogenic shock compared to Q1. Receiver operating characteristic analysis showed that the best cutoff value of SII to predict the in-hospital mortality was 1781 with 66% sensitivity and 74% specificity. Kaplan-Meier overall survivals for Q1, Q2, Q3 and Q4 were 97.6, 96.9, 91.6 and 81.0%, respectively. Cox proportional analysis for 3-year mortality demonstrated that Q3 and Q4 had an independent risk for mortality compared to Q1. CONCLUSION SII, a novel inflammatory index, was found to be a better predictor for in-hospital and long-term outcomes than traditional risk factors in patients with STEMI undergoing pPCI.
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Zhang H, Yan J, Niu J, Wang H, Li X. Association between lead and cadmium co-exposure and systemic immune inflammation in residents living near a mining and smelting area in NW China. CHEMOSPHERE 2022; 287:132190. [PMID: 34826933 DOI: 10.1016/j.chemosphere.2021.132190] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/02/2021] [Accepted: 09/04/2021] [Indexed: 06/13/2023]
Abstract
Exposure to both cadmium (Cd) and lead (Pb) can promote systemic inflammation. However, the effects of combined exposure to environmental levels of Cd and Pb on systemic immune inflammation have not been fully clarified. A total of 486 subjects (313 women and 173 men) living in either a control area or heavy metal-polluted area were included. Blood Cd and Pb and immune inflammation biomarkers were determined, including the eosinophil-lymphocyte ratio (ELR), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), and systemic immune-inflammation index (SII); moreover, the associations between exposure markers and systemic inflammation markers were analysed. The exposure levels in the polluted area were significantly higher than those in the control area. The NLR, PLR, and SII of subjects in the polluted area were higher and the LMR was lower than in the control area. Blood Pb and Cd levels are associated with elevated or decreased immune inflammation biomarkers in subjects from the exposed and control areas. Furthermore, co-exposure to both Cd and Pb was divided into high, middle, and low exposure groups. The subjects in the high co-exposure group displayed higher levels of ELR, NLR, and SII compared with the middle and low co-exposure group, and LMR levels displayed the opposite trend. Our data demonstrate that Cd and Pb co-exposure is associated with systemic immune inflammation, and the immune inflammatory response is aggravated with an increased co-exposure to Cd and Pb.
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Affiliation(s)
- Honglong Zhang
- The First School of Clinical Medical, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Jun Yan
- The First School of Clinical Medical, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China; Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China; Key Laboratory of Biotherapy and Regenerative Medicine of Gansu Province, Lanzhou, 730000, Gansu, People's Republic of China; Hepatopancreatobiliary Surgery Institute of Gansu Province, Medical College Cancer Center of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Jingping Niu
- Institute of Occupational and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Haiping Wang
- The First School of Clinical Medical, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China; Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China; Key Laboratory of Biotherapy and Regenerative Medicine of Gansu Province, Lanzhou, 730000, Gansu, People's Republic of China; Hepatopancreatobiliary Surgery Institute of Gansu Province, Medical College Cancer Center of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Xun Li
- The First School of Clinical Medical, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China; Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China; Key Laboratory of Biotherapy and Regenerative Medicine of Gansu Province, Lanzhou, 730000, Gansu, People's Republic of China; Hepatopancreatobiliary Surgery Institute of Gansu Province, Medical College Cancer Center of Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China.
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12
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The Prognostic Significance of Neutrophil to Lymphocyte Ratio (NLR), Monocyte to Lymphocyte Ratio (MLR) and Platelet to Lymphocyte Ratio (PLR) on Long-Term Survival in Off-Pump Coronary Artery Bypass Grafting (OPCAB) Procedures. BIOLOGY 2021; 11:biology11010034. [PMID: 35053032 PMCID: PMC8772913 DOI: 10.3390/biology11010034] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/18/2021] [Accepted: 12/22/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Cardiovascular diseases, apart from commonly known risk factors, are related to inflammation. There are several simple novel markers proposed to present the relation between inflammatory reactions activation and atherosclerotic changes. They are easily available from whole blood count and include neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), and platelets to lymphocyte ratio (PLR). The RDW results were excluded from the analysis. METHOD AND RESULTS The study based on retrospective single-centre analysis of 682 consecutive patients (131 (19%) females and 551 (81%) males) with median age of 66 years (60-71) who underwent off-pump coronary artery bypass grafting (OPCAB) procedure. During the median 5.3 +/- 1.9 years follow-up, there was a 87% cumulative survival rate. The laboratory parameters including preoperative MLR > 0.2 (HR 2.46, 95% CI 1.33-4.55, p = 0.004) and postoperative NLR > 3.5 (HR 1.75, 95% CI 1.09-2.79, p = 0.019) were found significant for long-term mortality prediction in multivariable analysis. CONCLUSION Hematological indices NLR and MLR can be regarded as significant predictors of all-cause long-term mortality after OPCAB revascularization. Multivariable analysis revealed preoperative values of MLR > 0.2 and postoperative values of NLR > 3.5 as simple, reliable factors which may be applied into clinical practice for meticulous postoperative monitoring of patients in higher risk of worse prognosis.
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13
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Li C, Fan H, Liu Y, Zeng L, Chen P, Duan C, Liang H, He P. The monocyte to high-density lipoprotein cholesterol ratio and outcomes in type 2 diabetes mellitus patients with non-ST-segment elevation acute coronary syndrome. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1627. [PMID: 34926671 PMCID: PMC8640916 DOI: 10.21037/atm-21-4876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/14/2021] [Indexed: 12/15/2022]
Abstract
Background The monocyte to high-density lipoprotein cholesterol ratio (MHR) has been demonstrated as a new marker of inflammation. However, at present, the prognostic value of MHR in type 2 diabetes mellitus (T2DM) accompanied with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) undergoing percutaneous coronary intervention (PCI) is unclear. Methods T2DM patients with NSTE-ACS undergoing PCI were consecutively enrolled from January 1, 2010 to December 31, 2014 and divided according to MHR value tertiles. Baseline, procedural, and follow-up data were collected. The primary outcomes were in-hospital major adverse clinical events (MACE). The prespecified secondary outcomes included any bleeding [as indicated by Bleeding Academic Research Consortium definition (BARC) grades 1–5] and death during follow-up. Results Of the 1,405 enrolled patients, the rates of in-hospital MACE (0.2%, 0.2%, and 1.3%, P=0.043) and bleeding (12.4%, 12.2%, and 17.1%, P=0.048) increased significantly in high MHR tertiles. After 1 year of follow-up, the rates of bleeding (15.0%, 14.5%, and 22.2%, P=0.002) and all-cause death (1.5%, 1.7%, and 4.3%, P=0.010) were higher in higher MHR tertiles. Our results also suggested that MHR was an independent predictor of in-hospital MACE [adjusted odds ratio =8.36; 95% confidence interval (CI): 1.57–44.47; P=0.013] and long-term bleeding (adjusted hazard ratio =1.21; 95% CI: 1.07–1.37; P=0.002). Receiver-operating characteristic curve analysis indicated that MHR >0.022 had a sensitivity of 75.0% and specificity of 72.7% for predicting in-hospital MACE [area under the curve (AUC) =0.722; 95% CI: 0.51–0.933; P=0.040]. Furthermore, Kaplan-Meier curves showed that a higher risk of all-cause death in long-term follow-up was prevalent in patients with high MHR (P=0.033). Conclusions The increased level of MHR was related to in-hospital MACE and long-term bleeding events in T2DM patients with NSTE-ACS undergoing PCI.
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Affiliation(s)
- Chen Li
- Department of Cardiology, Guangdong Provincial People's Hospital of Nanhai Hospital, the Second Hospital of Nanhai District Foshan City, Foshan, China
| | - Hualin Fan
- School of Medicine, South China University of Technology, Guangzhou, China
| | - Yuanhui Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Lihuan Zeng
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Pengyuan Chen
- Department of Cardiology, Guangdong Provincial People's Hospital of Nanhai Hospital, the Second Hospital of Nanhai District Foshan City, Foshan, China
| | - Chongyang Duan
- Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China
| | - Huasheng Liang
- Department of Cardiology, Guangdong Provincial People's Hospital of Nanhai Hospital, the Second Hospital of Nanhai District Foshan City, Foshan, China
| | - Pengcheng He
- Department of Cardiology, Guangdong Provincial People's Hospital of Nanhai Hospital, the Second Hospital of Nanhai District Foshan City, Foshan, China.,School of Medicine, South China University of Technology, Guangzhou, China.,Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
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14
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Keskin M, Öcal L, Cerşit S, Yılmaz C, Küp A, Çelik M, Doğan S, Koyuncu A, Kaya A, Turkmen MM. The Predictive Role of a Novel Risk Index in Patients Undergoing Carotid Artery Stenting: Systemic Immune-Inflammation Index. J Stroke Cerebrovasc Dis 2021; 30:105955. [PMID: 34242858 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105955] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/28/2021] [Accepted: 06/13/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Inflammatory mechanisms play an important role in both atherosclerosis and stroke. There are several inflammatory peripheral blood count markers associated with carotid artery stenosis degree, symptomatic carotid artery lesions and carotid artery stent restenosis that reported in previous studies. However, the prognostic role of the blood cell counts and their ratios in predicting in-hospital and long-term outcomes in patients undergoing carotid artery stenting (CAS) has not been comprehensively investigated. Systemic immune-inflammation index (SII) proved its' efficiency in patients with solid tumors and its' role was rarely examined in cardiovascular disorders and stroke. The current study evaluated the effect of this novel risk index on in-hospital and long-term outcomes in a large patient population who underwent CAS. METHOD A total of 732 patients with carotid artery stenosis who underwent CAS were enrolled to the study. SII was calculated using the following formula: neutrophil-to-lymphocyte ratio × total platelet count in the peripheral blood (per mm3) and the patients were stratified accordingly: T1, T2 and T3. In-hospital and 5-year outcomes were compared between the tertiles of SII. RESULTS During the hospitalization, major stroke, ipsilateral stoke, myocardial infarction, death and major adverse cardiovascular events (MACE) rates were significantly higher in high SII level (T3) compared to SII levels (T1 and 2). In long-term outcomes, ipsilateral stroke, major stroke, transient ischemic attack, death, and MACE were significantly higher in the patients with higher SII level (T3). The 5-year Kaplan-Meier overall survival for T1, T2, and T3 were 97.5%, 96.7% and 86.0% respectively. In-hospital and 5-year regression analyses demonstrated that high SII was independently associated with MACE and mortality. CONCLUSION SII was independently associated with in-hospital and long-term clinical outcomes in patients undergoing CAS. Immune and inflammation status, as assessed easily and quickly using SII, has a good discriminative value in these patients.
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Affiliation(s)
- Muhammed Keskin
- Cardiology, Bahcesehir University, Faculty of Medicine, Istanbul, Turkey.
| | - Lütfi Öcal
- Cardiology, Health Sciences University, Kartal Koşuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Sinan Cerşit
- Cardiology, Health Sciences University, Kartal Koşuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Cemalettin Yılmaz
- Cardiology, Health Sciences University, Kartal Koşuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Ayhan Küp
- Cardiology, Health Sciences University, Kartal Koşuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Çelik
- Cardiology, Health Sciences University, Kartal Koşuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Selami Doğan
- Cardiology, Bahcesehir University, Faculty of Medicine, Istanbul, Turkey
| | | | - Adnan Kaya
- Cardiology, Duzce University, Duzce, Turkey
| | - Mehmet Muhsin Turkmen
- Cardiology, Health Sciences University, Kartal Koşuyolu Heart Training and Research Hospital, Istanbul, Turkey
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15
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Meng YF, Pu Q, Ma Q, Zhu W, Li XY. Neutrophil/Lymphocyte Ratio as an Inflammatory Predictor of Dry Eye Disease: A Case-Control Study. Ther Clin Risk Manag 2021; 17:259-266. [PMID: 33790566 PMCID: PMC8001663 DOI: 10.2147/tcrm.s298156] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/05/2021] [Indexed: 12/14/2022] Open
Abstract
Background The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been used as indicators of inflammation, however, their roles in dry eye disease (DED) patients require advanced study. Materials and Methods A total of 104 DED cases and 97 healthy controls from January 2020 to May 2020 were enrolled in this study. The dry eye related clinical variables, including Schirmer I test, tear break-up time (TBUT), corneal fluorescein staining (CFS) and Ocular Surface Disease Index (OSDI), were detected in all the participants. Besides, the NLR and PLR pattern in DED cases were detected and their potential value as inflammatory predictors of DED were evaluated. In advanced analyses, the correlation between NLR and DED severity was examined. Results The NLR and PLR were 2.59 ± 1.25 and 117.48 ± 54.68 in the DED group, respectively, while they were 2.20 ± 1.24 and 115.48 ± 54.33 in the control group, respectively. The NLR was higher in the DED group (p = 0.027), however, PLR was not significantly different compared with the control group (p = 0.951). In advanced analyses, it was found that more severe TBUT, CFS, and OSDI scores were detected in the high NLR group (NLR ≥2.145, p = 0.003, 0.013, and 0.017, respectively) compared with the low NLR group (NLR <2.145). Conclusion The NLR value, but not PLR, of DED patients was higher than that of healthy controls. The NLR could be used as an inflammatory predictor to estimate the severity of DED.
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Affiliation(s)
- Yi-Fang Meng
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.,Department of Ophthalmology, Changshu No. 2 People's Hospital, Changshu, Jiangsu, People's Republic of China
| | - Qi Pu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Qian Ma
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Wei Zhu
- Department of Ophthalmology, Changshu No. 2 People's Hospital, Changshu, Jiangsu, People's Republic of China
| | - Xin-Yu Li
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
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16
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Li L, Ma Y, Geng X, Tan Z, Wang J, Cui C, Wang HL, Shang X. Platelet-to-lymphocyte ratio relates to poor prognosis in elderly patients with acute myocardial infarction. Aging Clin Exp Res 2021; 33:619-624. [PMID: 32301030 DOI: 10.1007/s40520-020-01555-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 04/02/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND The platelet to lymphocyte ratio (PLR) is a novel biomarker to predict the prognosis of acute myocardial infarction (AMI) patients. AIM The study aimed to evaluate the in-hospital outcomes of elderly patients with AMI and assessed the prognostic value of PLR on in-hospital adverse events. METHODS A total of 1,001 patients were divided into an older group (n = 560) and a younger group (n = 441) based on age ≥ 60 years and successfully underwent primary percutaneous coronary intervention (PCI) within 12 h after presentation. Total white blood cells (WBCs), neutrophils, lymphocytes, and platelets counts were measured at admission. RESULTS The incidence of heart rupture, acute heart failure, total adverse events, and death resulting from all events were significantly higher in patients ≥ 60 years than in younger patients, whereas the incidence of postoperative angina and reinfarction were similar between groups. Regarding blood counts, total white blood cells, neutrophils, lymphocytes, and platelets were lower in the older group than in the younger group. The platelet-to-lymphocyte ratio (PLR) was significantly higher in the older group. In receiver operating characteristic curve analysis, high PLR > 147 predicted adverse events (specificity 72% and sensitivity 63%). In multiple logistic regression analysis, age, hypertension, and PLR were identified as independent predictors of adverse events. CONCLUSIONS The in-hospital outcomes of elderly patients with acute myocardial infarction were poor. PLR was an independent risk factor for in-hospital adverse events, which suggested that strong inflammation and prothrombotic status may contribute to the poor prognoses of elderly patients.
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17
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Guclu K, Celik M. Prognostic Value of Inflammation Parameters in Patients With Non-ST Elevation Acute Coronary Syndromes. Angiology 2020; 71:825-830. [PMID: 32597198 DOI: 10.1177/0003319720936500] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Inflammation parameters can predict the severity of coronary artery disease and predict long-term mortality. However, there is no study in which these parameters were evaluated together. We compared the prognostic values of inflammation parameters in predicting long-term mortality in patients with non-ST elevation acute coronary syndrome (NSTE-ACS). Consecutive patients with NSTE-ACS (n = 170) were included in the study. Monocyte/high-density lipoprotein cholesterol (HDL-C) ratio (MHR), lymphocyte/monocyte ratio (LMR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), total cholesterol/HDL-C ratio (TC/HDL-C), triglyceride /HDL-C ratio (TG/HDL-C), total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index, and ischemia-modified albumin (IMA) were measured. Total antioxidant status and TOS variables were significant independent predictors of mortality. When 1.17 value is taken as a cutoff point of TAS values, the sensitivity (70.0%) and specificity (77.39%) values calculated for this value indicate that TAS variable has a predictive value on mortality. Monocyte/high-density lipoprotein cholesterol ratio, LMR, NLR, PLR, TC/HDL-C, TG/HDL-C, TOS, and IMA levels could not be used alone in the diagnosis, severity assessment, and predicting future mortality of NSTE-ACS. Only TAS levels had a predictive value on mortality.
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Affiliation(s)
- Kenan Guclu
- Department of Biochemistry, Kirsehir Training and Research Hospital, Kirsehir, Turkey
| | - Mustafa Celik
- Department of Cardiology, 317030Ahi Evran University Training and Research Hospital, Kirsehir, Turkey
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18
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Chung J, Bae J, Kwon Y, Yoon HK, Yoo S, Lee HJ, Park SK, Kim JT, Kim WH. Neutrophil/Lymphocyte Ratio in Patients Undergoing Noncardiac Surgery After Coronary Stent Implantation. J Cardiothorac Vasc Anesth 2020; 34:1516-1525. [DOI: 10.1053/j.jvca.2019.10.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 09/29/2019] [Accepted: 10/06/2019] [Indexed: 12/19/2022]
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19
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Somaschini A, Cornara S, Demarchi A, Mandurino-Mirizzi A, Baldi E, Ferlini M, Crimi G, Camporotondo R, Gnecchi M, Oltrona Visconti L, De Ferrari GM. The unfavourable inflammatory response in elderly patients after myocardial infarction: should we talk of 'dysflammaging'? J Cardiovasc Med (Hagerstown) 2020; 21:340-342. [PMID: 31972747 DOI: 10.2459/jcm.0000000000000925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Alberto Somaschini
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - Fondazione IRCCS Policlinico San Matteo.,Department of Molecular Medicine, Unit of Cardiology, Università degli studi di Pavia, Pavia, Italy
| | - Stefano Cornara
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - Fondazione IRCCS Policlinico San Matteo.,Department of Molecular Medicine, Unit of Cardiology, Università degli studi di Pavia, Pavia, Italy
| | - Andrea Demarchi
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - Fondazione IRCCS Policlinico San Matteo.,Department of Molecular Medicine, Unit of Cardiology, Università degli studi di Pavia, Pavia, Italy
| | - Alessandro Mandurino-Mirizzi
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - Fondazione IRCCS Policlinico San Matteo.,Department of Molecular Medicine, Unit of Cardiology, Università degli studi di Pavia, Pavia, Italy
| | - Enrico Baldi
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - Fondazione IRCCS Policlinico San Matteo.,Department of Molecular Medicine, Unit of Cardiology, Università degli studi di Pavia, Pavia, Italy
| | - Marco Ferlini
- Division of Cardiology - Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Gabriele Crimi
- Division of Cardiology - Fondazione IRCCS Policlinico San Matteo, Pavia
| | - Rita Camporotondo
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - Fondazione IRCCS Policlinico San Matteo
| | - Massimiliano Gnecchi
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - Fondazione IRCCS Policlinico San Matteo.,Department of Molecular Medicine, Unit of Cardiology, Università degli studi di Pavia, Pavia, Italy
| | | | - Gaetano M De Ferrari
- Division of Cardiology, Città della Salute e della Scienza Hospital, Department of Medical Sciences, University of Torino, Torino, Italy
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20
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Zhang L, Li X, Wang D, Lv H, Si X, Li X, Sun Y, Wang D, Chen K, Kang X, Lou X, Zhang G, Ma N. Risk Factors of Recurrent Ischemic Events after Acute Noncardiogenic Ischemic Stroke. Curr Pharm Des 2020; 25:4827-4834. [PMID: 31663472 DOI: 10.2174/1381612825666191029103756] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/21/2019] [Indexed: 11/22/2022]
Abstract
Background:
A considerable proportion of acute noncardiogenic ischemic stroke patients continue to
experience recurrent ischemic events after standard therapy.
Aim:
We aimed to identify risk factors for recurrent ischemic event prediction at an early stage.
Methods :
286 non-cardioembolic ischemic stroke patients with the onset of symptoms within 24 hours were
enrolled. Vascular risk factors, routine laboratory data on admission, thromboelastography test seven days after
clopidogrel therapy and any recurrent events within one year were assessed. Patients were divided into case group
(patients with clinical adverse events, including ischemic stokes, transient ischemic attack, myocardial infarction
and vascular related mortality) and control group (events-free patients). The risk of the recurrent ischemic events
was determined by the receiver operating characteristic curve and multivariable logistic regression analysis.
Results:
Clinical adverse events were observed in 43 patients (case group). The mean levels of Mean Platelet
Volume (MPV), Platelet/Lymphocyte Ratio (PLR), Lymphocyte Count (LY) and Fibrinogen (Fib) on admission
were significantly higher in the case group as compared to the control group (P<0.001). Seven days after clopidogrel
therapy, the ADP-induced platelet inhibition rate (ADP%) level was lower in the case group, while the
Maximum Amplitude (MA) level was higher in the case group as compared to the control group (P<0.01). The
Area Under the Curve (AUC) of receiver operating characteristic(ROC) curve of LY, PLR, , Fib, MA, ADP% and
MPV were 0.602, 0.614, 0.629, 0.770, 0.800 and 0.808, respectively. The logistic regression analysis showed that
MPV, ADP% and MA were indeed predictive factors.
Conclusion:
MPV, ADP% and MA were risk factors of recurrent ischemic events after acute noncardiogenic
ischemic stroke. Urgent assessment and individual drug therapy should be offered to these patients as soon as
possible.
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Affiliation(s)
- Limin Zhang
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Xingang Li
- Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Dongzhi Wang
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Hong Lv
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Xuezhong Si
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Xiao Li
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Yuehong Sun
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Dan Wang
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Kelin Chen
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Xixiong Kang
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Xin Lou
- Department of Radiology, Chinese PLA General Hospital, Beijing, 100853, China
| | - Guojun Zhang
- Laboratory Diagnosis Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Ning Ma
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100070, China
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21
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Somaschini A, Cornara S, Demarchi A, Mandurino-Mirizzi A, Fortuni F, Crimi G, Ferlini M, Camporotondo R, Gnecchi M, Visconti LO, De Ferrari GM. Neutrophil to platelet ratio: A novel prognostic biomarker in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. Eur J Prev Cardiol 2019; 27:2338-2340. [PMID: 31841054 DOI: 10.1177/2047487319894103] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Alberto Somaschini
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Molecular Medicine, Unit of Cardiology, University of Pavia, Pavia, Italy
| | - Stefano Cornara
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Molecular Medicine, Unit of Cardiology, University of Pavia, Pavia, Italy
| | - Andrea Demarchi
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Molecular Medicine, Unit of Cardiology, University of Pavia, Pavia, Italy
| | - Alessandro Mandurino-Mirizzi
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Molecular Medicine, Unit of Cardiology, University of Pavia, Pavia, Italy
| | - Federico Fortuni
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Molecular Medicine, Unit of Cardiology, University of Pavia, Pavia, Italy
| | - Gabriele Crimi
- Division of Cardiology - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Ferlini
- Division of Cardiology - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Rita Camporotondo
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Massimiliano Gnecchi
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Department of Molecular Medicine, Unit of Cardiology, University of Pavia, Pavia, Italy
| | | | - Gaetano M De Ferrari
- Division of Cardiology, "Città della Salute e della Scienza di Torino" Hospital, Department of Medical Sciences, University of Turin, Italy
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22
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Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio Predict Severity and Prognosis of Lower Limb Arteriosclerosis Obliterans. Ann Vasc Surg 2019; 64:221-227. [PMID: 31655109 DOI: 10.1016/j.avsg.2019.09.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/24/2019] [Accepted: 09/12/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are 2 markers of inflammation, which are associated with worse cardiovascular disease outcomes. Here, we aimed to determine the association between these ratios and disease severity and evaluate predictive validity of the NLR and PLR in lower limb arteriosclerosis obliterans (ASO). METHODS We evaluated 211 patients with a diagnosis of ASO from January 2016 to December 2018 at Shanghai Jiaotong University Renji Hospital. The NLR and PLR were accessed from routinely drawn peripheral venous blood at the ward of vascular surgery during hospitalization. The association between the NLR and PLR with baseline characteristics, disease severity, and one-year outcomes were determined, respectively. RESULTS Both the NLR and PLR showed significant values on predicting disease severity. A higher NLR (P = 0.001) and PLR (P < 0.001) were associated with lower ankle-brachial index and worse clinical presentation. Both the NLR and PLR are positively correlated with one-year readmission rate (P < 0.001, P = 0.001, respectively). Both the NLR and PLR also positively correlated with the tissue loss rate and one-year mortality (P = 0.007, P = 0.034, respectively). CONCLUSIONS The NLR and PLR show a positive association with the severity of lower extremity peripheral artery disease, both higher ratios correlate with poor prognosis, especially, the risk of one-year readmission. A higher NLR also correlates with one-year mortality.
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Altay S, Gürdoğan M, Keskin M, Kardaş F, Çakır B. The Inflammation-Based Glasgow Prognostic Score as a Prognostic Factor in Patients with Intensive Cardiovascular Care Unit. ACTA ACUST UNITED AC 2019; 55:medicina55050139. [PMID: 31096693 PMCID: PMC6572028 DOI: 10.3390/medicina55050139] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/22/2019] [Accepted: 05/10/2019] [Indexed: 12/23/2022]
Abstract
Background: The Glasgow prognostic score (GPS), which is obtained from a combination of C-reactive protein (CRP) and serum albumin level, predicts poor prognoses in many cancer types. Systemic inflammation also plays an important role in pathogenesis of cardiovascular diseases. In this study, we aimed to investigate the effect of inflammation-based GPS on in-hospital and long-term outcomes in patients hospitalized in intensive cardiovascular care unit (ICCU). Methods: A total of 1004 consecutive patients admitted to ICCU were included in the study, and patients were divided into three groups based on albumin and CRP values as GPS 0, 1, and 2. Patients’ demographic, clinic, and laboratory findings were recorded. In-hospital and one-year mortality rates were compared between groups. Results: Mortality occurred in 109 (10.8%) patients in in-hospital period, 82 (8.1%) patients during follow-up period, and thus, cumulative mortality occurred in 191 (19.0%) patients. Patients with a high GPS score had a higher rate of comorbidities and represented increased inflammatory evidence. In the multivariate regression model there was independent association with in-hospital mortality in GPS 1 patients compared to GPS 0 patients (Odds ratio, (OR); 5.52, 95% CI: 1.2–16.91, p = 0.025) and in GPS 2 patients compared to GPS 0 patients (OR; 7.01, 95% CI: 1.39–35.15, p = 0.018). A higher GPS score was also associated with a prolonged ICCU and hospital stay, and increased re-hospitalization in the follow-up period. Conclusion: Inflammation based GPS is a practical tool in the prediction of worse prognosis both in in-hospital and one-year follow-up periods in ICCU patients.
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Affiliation(s)
- Servet Altay
- Department of Cardiology, School of Medicine, Trakya University, 22030 Edirne, Turkey.
| | - Muhammet Gürdoğan
- Department of Cardiology, School of Medicine, Trakya University, 22030 Edirne, Turkey.
| | - Muhammed Keskin
- Department of Cardiology Health Sciences University, Sultan Abdulhamid Han Training and Research Hospital, 34010 Istanbul, Turkey.
| | - Fatih Kardaş
- Department of Cardiology, School of Medicine, Trakya University, 22030 Edirne, Turkey.
| | - Burcu Çakır
- Department of Cardiology, School of Medicine, Trakya University, 22030 Edirne, Turkey.
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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.
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Diniz LR, de Lima SG, de Amorim Garcia JM, de Oliveira Diniz KL. Neutrophil to Lymphocyte Ratio as a Prognostic Predictor in Older People With Acute Coronary Syndrome. Angiology 2018; 70:264-271. [PMID: 30153747 DOI: 10.1177/0003319718796565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The neutrophil to lymphocyte ratio (NLR) at admission is a prognostic marker for acute coronary syndrome (ACS). However, no study was performed exclusively with older people. The present study evaluated the NLR in older people with ACS as a predictor of death, combined major in-hospital outcomes (death, stroke, reinfarction), hospital stay, ventricular ejection fraction, use of vasoactive drugs, and extent of coronary artery disease. We conducted a retrospective cohort study with in-hospital follow-up using data from a single center in Recife, Brazil. Patients aged 60 and older admitted with ACS were selected. The patients were followed until discharge or death. A total of 272 individuals were evaluated; 55.8% were men and the mean age was 73 years. The NLR was not a predictor of in-hospital death. A higher NLR upon admission was associated with a longer hospital stay (β = 0.131; 95% confidence interval [CI]: 0.017-0.246; P = .024) and an ejection fraction <50% (relative risk = 2.1; 95% CI: 1.19-3.57; P = .001). The other outcomes did not reach significance. The NLR was associated with a longer hospital stay and a left ventricular ejection fraction <50% in older people with ACS.
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Affiliation(s)
- Lucas Rampazzo Diniz
- Division of Geriatrics, Hospital das Clínicas, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Sandro Gonçalves de Lima
- Department of Internal Medicine, Division of Cardiology, Hospital das Clínicas, Federal University of Pernambuco, Recife, Pernambuco, Brazil
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Pulmoner Emboli Hastalarında Nötrofil/Lenfosit Oranı ve Trombosit/Lenfosit Oranı. JOURNAL OF CONTEMPORARY MEDICINE 2018. [DOI: 10.16899/gopctd.410396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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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: 13] [Impact Index Per Article: 2.2] [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.
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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
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Xu N, Tang XF, Yao Y, Zhao X, Chen J, Gao Z, Yang Y, Gao RL, Xu B, Yuan JQ. Predictive value of neutrophil to lymphocyte ratio in long-term outcomes of left main and/or three-vessel disease in patients with acute myocardial infarction. Catheter Cardiovasc Interv 2018; 91:551-557. [PMID: 29330938 DOI: 10.1002/ccd.27495] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 12/27/2017] [Indexed: 11/05/2022]
Affiliation(s)
- Na Xu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases; Chinese Academy of Medical Sciences and Peking Union Medical College; Beilishi Road No. 167, Xicheng District, Beijing 100037 People's Republic of China
- Peking Union Medical College; Beijing 100037 People's Republic of China
| | - Xiao-Fang Tang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases; Chinese Academy of Medical Sciences and Peking Union Medical College; Beilishi Road No. 167, Xicheng District, Beijing 100037 People's Republic of China
- Peking Union Medical College; Beijing 100037 People's Republic of China
| | - Yi Yao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases; Chinese Academy of Medical Sciences and Peking Union Medical College; Beilishi Road No. 167, Xicheng District, Beijing 100037 People's Republic of China
- Peking Union Medical College; Beijing 100037 People's Republic of China
| | - Xueyan- Zhao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases; Chinese Academy of Medical Sciences and Peking Union Medical College; Beilishi Road No. 167, Xicheng District, Beijing 100037 People's Republic of China
- Peking Union Medical College; Beijing 100037 People's Republic of China
| | - Jue- Chen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases; Chinese Academy of Medical Sciences and Peking Union Medical College; Beilishi Road No. 167, Xicheng District, Beijing 100037 People's Republic of China
- Peking Union Medical College; Beijing 100037 People's Republic of China
| | - Zhan- Gao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases; Chinese Academy of Medical Sciences and Peking Union Medical College; Beilishi Road No. 167, Xicheng District, Beijing 100037 People's Republic of China
- Peking Union Medical College; Beijing 100037 People's Republic of China
| | - Yuejin- Yang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases; Chinese Academy of Medical Sciences and Peking Union Medical College; Beilishi Road No. 167, Xicheng District, Beijing 100037 People's Republic of China
- Peking Union Medical College; Beijing 100037 People's Republic of China
| | - Run-Lin Gao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases; Chinese Academy of Medical Sciences and Peking Union Medical College; Beilishi Road No. 167, Xicheng District, Beijing 100037 People's Republic of China
- Peking Union Medical College; Beijing 100037 People's Republic of China
| | - Bo Xu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases; Chinese Academy of Medical Sciences and Peking Union Medical College; Beilishi Road No. 167, Xicheng District, Beijing 100037 People's Republic of China
- Peking Union Medical College; Beijing 100037 People's Republic of China
| | - Jin-Qing Yuan
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases; Chinese Academy of Medical Sciences and Peking Union Medical College; Beilishi Road No. 167, Xicheng District, Beijing 100037 People's Republic of China
- Peking Union Medical College; Beijing 100037 People's Republic of China
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Trakarnwijitr I, Li B, Adams H, Layland J, Garlick J, Wilson A. Age modulates the relationship between platelet-to-lymphocyte ratio and coronary artery disease. Int J Cardiol 2017; 248:349-354. [DOI: 10.1016/j.ijcard.2017.06.127] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 06/20/2017] [Accepted: 06/30/2017] [Indexed: 01/31/2023]
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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.
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Efe E, Kocayiğit I, Türker PM, Murat K, Erkan A, Sedat T, Alper Ç, Necati AM, Gökhan VM, Bahri A. Platelet-to-lymphocyte ratio but not neutrophil-to-lymphocyte ratio predicts high on-treatment platelet reactivity in clopidogrel-treated patients with acute coronary syndrome. Indian J Pharmacol 2017; 48:355-359. [PMID: 27756943 PMCID: PMC4980920 DOI: 10.4103/0253-7613.186205] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Dual antiplatelet therapy (DAPT), consisting of clopidogrel and aspirin, is the main-stay treatment of acute coronary syndromes (ACS). However, major adverse cardiovascular events may occur even in patients undergoing DAPT, and this has been related to the variable pharmacodynamic efficacy of these drugs, especially clopidogrel. Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are novel inflammatory markers for cardiovascular risk stratification, which may reflect an inflammatory state and thus high on-treatment platelet reactivity (HPR). METHODS We investigated the usefulness of PLR and NLR in predicting HPR in clopidogrel-treated patients with ACS. A total of 244 patients were enrolled in this study, and 43 of them were nonresponsive to clopidogrel. RESULTS Logistic regression analysis indicated that PLR was significantly associated with HPR (P < 0.001). Using a cutoff level of 331, PLR predicted HPR with a sensitivity of 73% and a specificity of 69% (odds ratio: 376.15, 95% confidence interval = 37.813-3741.728 P < 0.001, receiver operating characteristic curve: 0.885). CONCLUSIONS We suggest that more attention should be paid to the PLR values of these patients on admission to identify individuals who may not benefit from clopidogrel during the course of ACS.
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Affiliation(s)
- Edem Efe
- Tınaztepe Hospital, Department of Cardiology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Ibrahim Kocayiğit
- Department of Cardiology, Izmir Bergama State Hospital, Izmir, Turkey
| | | | - Küçükukur Murat
- Department of Cardiology, Dokuz Eylül University Faculty of Medicine, Turkey
| | - Alpaslan Erkan
- Department of Cardiology, Uşak State Hospital, Usak, Turkey
| | - Taş Sedat
- Department of Cardiology, Uşak State Hospital, Usak, Turkey
| | - Çil Alper
- Department of Cardiology, Uşak State Hospital, Usak, Turkey
| | | | | | - Akdeniz Bahri
- Department of Cardiology, Uşak State Hospital, Usak, Turkey
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Takeshita S, Kanai T, Kawamura Y, Yoshida Y, Nonoyama S. A comparison of the predictive validity of the combination of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio and other risk scoring systems for intravenous immunoglobulin (ivig)-resistance in Kawasaki disease. PLoS One 2017; 12:e0176957. [PMID: 28542183 PMCID: PMC5441585 DOI: 10.1371/journal.pone.0176957] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/19/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND We recently reported that the combination of the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) is a novel and useful predictor of intravenous immunoglobulin (IVIG)-resistance in Kawasaki disease (KD). In the present study, to evaluate the effectiveness of the new risk score, we compared its predictive validity to that of previously reported risk scores. MATERIALS AND METHODS The laboratory records of 437 patients with KD before IVIG therapy were retrospectively analyzed, and the IVIG-responsive (n = 344) and IVIG-resistant (n = 93) patients were compared. The validity of the new score (the combination of NLR≥3.83 and PLR≥150) for predicting IVIG resistance in KD was compared to that of the Kobayashi, Egami and Sano risk scores. RESULTS The new score and the Kobayashi score displayed high sensitivity (0.72 and 0.70 respectively) and specificity (0.67 and 0.68 respectively), while the Egami and Sano scores showed high specificity (0.71 and 0.81 respectively) but relatively low sensitivity (0.56 and 0.45 respectively). The odds ratios (ORs) for the new score, the Kobayashi score, the Egami score and the Sano score were 5.34 (95% confidence interval [CI] 3.22-8.85), 4.87 (95% CI 2.96-8.01), 3.14 (95% CI 1.96-5.03) and 3.53 (95% CI 2.17-5.77) respectively. CONCLUSIONS The predictive validity of the combination of NLR≥3.83 and PLR≥150, which is a simple and convenient indicator, was equal to or higher than that of the other risk scores. This suggests that the new score could be a widely available marker for predicting IVIG resistance in KD.
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Affiliation(s)
- Seiichiro Takeshita
- Division of Nursing, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Takashi Kanai
- Department of Pediatrics, National Defense Medical College, Tokorozawa, Saitama, Japan
- Department of Pediatrics, Japan Self-Defense Forces Central Hospital, Setagaya, Tokyo, Japan
| | - Yoichi Kawamura
- Department of Pediatrics, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Yusuke Yoshida
- Department of Pediatrics, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Shigeaki Nonoyama
- Department of Pediatrics, National Defense Medical College, Tokorozawa, Saitama, Japan
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Asahina A, Kubo N, Umezawa Y, Honda H, Yanaba K, Nakagawa H. Neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and mean platelet volume in Japanese patients with psoriasis and psoriatic arthritis: Response to therapy with biologics. J Dermatol 2017; 44:1112-1121. [PMID: 28493493 DOI: 10.1111/1346-8138.13875] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 03/14/2017] [Indexed: 12/14/2022]
Abstract
Recent studies indicate the presence of systemic inflammation in psoriatic patients, and this inflammatory status is significantly associated with a range of comorbidities. The aim of this study was to evaluate the clinical significance of novel inflammatory biomarkers, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and mean platelet volume (MPV) in Japanese patients with plaque-type psoriasis (PsV) and psoriatic arthritis (PsA). One hundred and eighty-six patients with PsV and 50 patients with PsA treated with biologics, including infliximab, adalimumab and ustekinumab, were retrospectively analyzed before and after treatment. At baseline, NLR and PLR, as well as C-reactive protein (CRP), were significantly higher in PsA patients than those in PsV patients, and a significant correlation was found between NLR and PLR. In PsV patients, the NLR-high and PLR-high subgroups exhibited significantly higher Psoriasis Area and Severity Index scores compared with the NLR-low and PLR-low subgroups, respectively, and the NLR-high subgroup also showed higher CRP levels. MPV value was negatively associated with the presence of arthritis, but its association with inflammation was less clear than that of NLR or PLR. After treatment of the patients with biologics for up to 12 months, NLR and PLR decreased promptly in parallel with a decrease of CRP, irrespective of the type of biologics used. Altogether, these results indicate that both NLR and PLR may be useful markers to evaluate systemic inflammation in psoriatic patients. They may serve as simple, convenient and cost-effective biomarkers to monitor the disease course after systemic therapy.
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Affiliation(s)
- Akihiko Asahina
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
| | - Naoko Kubo
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yoshinori Umezawa
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiromi Honda
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
| | - Koichi Yanaba
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hidemi Nakagawa
- Department of Dermatology, The Jikei University School of Medicine, Tokyo, Japan
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Sun XP, Li J, Zhu WW, Li DB, Chen H, Li HW, Chen WM, Hua Q. Platelet to Lymphocyte Ratio Predicts Contrast-Induced Nephropathy in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Angiology 2017; 69:71-78. [PMID: 28464698 DOI: 10.1177/0003319717707410] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We investigated the relationship between platelet to lymphocyte ratio (PLR) and contrast-induced nephropathy (CIN) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). We enrolled 5719 patients in 3 tertiary hospitals from January 2005 to December 2010. The PLR was calculated as the ratio of platelet to lymphocyte counts on admission. Serum creatinine level was measured before and within 72 hours after contrast medium administration. To evaluate the relation between PLR and CIN, the 5719 patients were divided into a CIN group and a non-CIN group. Contrast-induced nephropathy occurred in 252 (4.4%) patients. Patients in the CIN group had significantly higher PLR than those in the non-CIN group (173.8 [62.3] and 116.2 [51.7], respectively; P < .001). In logistic regression analysis, PLR was an independent predictor of CIN (odds ratio: 1.432, 95% confidence interval: 1.205-1.816, P = .031), along with age, diabetes mellitus, creatinine, estimated glomerular filtration rate, and neutrophil to lymphocyte ratio. In conclusion, a higher PLR was an independent risk factor for the development of CIN in patients with STEMI undergoing pPCI.
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Affiliation(s)
- Xi-Peng Sun
- 1 Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jing Li
- 1 Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Wei-Wei Zhu
- 1 Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Dong-Bao Li
- 2 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hui Chen
- 2 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hong-Wei Li
- 2 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wen-Ming Chen
- 3 Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Qi Hua
- 1 Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China
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Xiang F, Chen R, Cao X, Shen B, Liu Z, Tan X, Ding X, Zou J. Monocyte/lymphocyte ratio as a better predictor of cardiovascular and all-cause mortality in hemodialysis patients: A prospective cohort study. Hemodial Int 2017; 22:82-92. [PMID: 28403540 DOI: 10.1111/hdi.12549] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Patients with chronic kidney disease, especially those with end-stage renal disease, have an increased risk of death. Previous studies have suggested neutrophil/lymphocyte ratio (NLR) was related to worse outcome in patients undergoing hemodialysis (HD). However, monocyte/lymphocyte ratio (MLR) has not been evaluated in HD patients. In this study, we prospectively studied the predictive value of MLR for all-cause and cardiovascular mortality in HD patients and compared it with NLR. METHODS Patients who had been on a HD treatment for at least 6 months were enrolled. MLR was calculated by dividing the monocyte count by the lymphocyte count. Survival outcomes were estimated using the Kaplan-Meier method and compared by the log-rank test. Univariate and multivariate analyses were performed to evaluate the prognostic impact of MLR and other clinical factors on all-cause and cardiovascular mortality. RESULTS Mortality rates for the lowest, middle, and highest MLR tertile group were 3.65, 7.02, and 11.15, respectively per 100 patient-years. The Kaplan-Meier analysis revealed that survival rates were significantly different among three MLR groups (P < 0.001). In multivariate Cox regression analyses, MLR was independently associated with all-cause mortality (HR 4.842; 95% CI, 2.091-11.214; P < 0.001) and cardiovascular mortality (HR 6.985, 95% CI 1.943-25.115, P = 0.003) as continuous variables. NLR was not an independent predictor of all-cause nor cardiovascular mortality after adjusted with MLR. CONCLUSIONS The main finding of the study suggest that higher MLR was a strong and independent predictor of all-cause and cardiovascular mortality and overwhelmed NLR among HD patients.
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Affiliation(s)
- Fangfang Xiang
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China
| | - Rongyi Chen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Key Lab of Kidney and Blood Purification, Shanghai, China
| | - Xuesen Cao
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Bo Shen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhonghua Liu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiao Tan
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaoqiang Ding
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Kidney and Dialysis, Shanghai, China
| | - Jianzhou Zou
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China.,Shanghai Key Lab of Kidney and Blood Purification, Shanghai, China
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Meng X, Chang Q, Liu Y, Chen L, Wei G, Yang J, Zheng P, He F, Wang W, Ming L. Determinant roles of gender and age on SII, PLR, NLR, LMR and MLR and their reference intervals defining in Henan, China: A posteriori and big-data-based. J Clin Lab Anal 2017; 32. [PMID: 28378887 DOI: 10.1002/jcla.22228] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 03/07/2017] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES By now, there are few data of the reference intervals (RIs) of SII, PLR, NLR, LMR and MLR. We aimed to establish RIs of SII, PLR, NLR, LMR and MLR for healthy persons. METHODS A retrospective analysis on a cohort of ostensibly healthy, aged no <18 years old physical examinees who took health examination from January to December in 2013 was conducted to explore influences of age and gender on SII, PLR, NLR, LMR and MLR and to establish their RIs. And another cohort of 450 persons in our hospital from January to July in 2016 is included for validations of RIs. RESULTS NLR, LMR and MLR were significantly different between gender groups (P=.010; P<.001; P<.001, separately), while SII and PLR were not (P=.137; P=.267, separately). While SII was not changed much between age groups (P=.842), PLR, NLR, LMR and MLR were significantly different (all with P<.001). RIs of SII, PLR, NLR, LMR and MLR were: SII: [161,701]; PLR: 18-65 year-old: [61,179]/>65 year-old: [55,179]; NLR: 18-65 year-old male: [0.90,2.94]/18-65 year-old female: [0.85,3.06]/>65 year-old male: [0.95,3.57]/aged >65 year-old female: [0.83,3.30]; LMR: 18-65 year-old male: [2.50,7.50]/18-65 year-old female: [2.75,8.50]/>65 year-old male: [2.16,7.41]/>65 year-old female: [2.40,8.33]; MLR: 18-65 year-old male: [0.12,0.35]/18-65 year-old female: [0.10,0.32]/>65 year-old male: [0.12,0.41]/>65 year-old male: [0.11,0.33]. CONCLUSIONS RIs of SII, PLR, NLR, LMR and MLR of people in central China were established and validated. It will benefit experimental design of the related studies and lead to better standardizations of SII, PLR, NLR, LMR and MLR for their clinical applications.
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Affiliation(s)
- Xianchun Meng
- Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
| | - Qian Chang
- Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
| | - Yuying Liu
- Physical Examination Department, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Ling Chen
- Clinical Laboratory, People's Hospital of Jiangyou, Mianyang, Sichuan, China
| | - Gaohui Wei
- Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
| | - Jingjing Yang
- Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
| | - Peiguo Zheng
- Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
| | - Fucheng He
- Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
| | - Wanhai Wang
- Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
| | - Liang Ming
- Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
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Yuan YD, Sun J, Li PF, Wei CL, Yu YH. [Values of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in predicting sensitivity to intravenous immunoglobulin in Kawasaki disease]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2017; 19:410-413. [PMID: 28407827 PMCID: PMC7389660 DOI: 10.7499/j.issn.1008-8830.2017.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 12/26/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To study the values of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in predicting the sensitivity to intravenous immunoglobulin (IVIG) in Kawasaki disease (KD). METHODS A retrospective cohort study was conducted in 404 children with newly diagnosed KD. The data on routine blood tests, NLR, and PLR were collected before and after IVIG treatment. The receiver operating characteristic (ROC) curve was used to determine the cut-off values of NLR and PLR in predicting the insensitivity to IVIG. A logistic regression analysis was used to identify independent predictive factors for insensitivity to IVIG. RESULTS Of all patients, 31 were insensitive to IVIG. Compared with the IVIG sensitivity group, the IVIG insensitivity group had a significantly higher incidence rate of coronary artery ectasia (P<0.01), a shorter course of disease when IVIG therapy was initiated (P<0.05), and significantly higher NLR, PLR, and C-reactive protein (CRP) level before and after treatment (P<0.05). The optimal cut-off values for NLR and PLR to predict IVIG insensitivity were 4.36 and 162 before IVIG treatment and 1.45 and 196 after treatment. The multivariate regression analysis showed that the course of disease before IVIG treatment, CRP before IVIG treatment, and NLR and PLR before and after IVIG treatment were independent predictive factors for IVIG insensitivity. CONCLUSIONS NLR and PLR can be used to predict IVIG insensitivity in children with KD.
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Affiliation(s)
- Ying-Di Yuan
- Department of Pediatrics, First People's Hospital of Lianyungang, Xuzhou Medical University, Lianyungang, Jiangsu 222002, China.
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Kiris T, Çelik A, Variş E, Akan E, Akyildiz ZI, Karaca M, Nazli C, Dogan A. Association of Lymphocyte-to-Monocyte Ratio With the Mortality in Patients With ST-Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention. Angiology 2017; 68:707-715. [PMID: 28056530 DOI: 10.1177/0003319716685480] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We investigated whether the lymphocyte-to-monocyte ratio (LMR) 48 hours after admission is related to 30-day and long-term mortality in patients with ST-elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention (PCI). We evaluated 318 consecutive patients with STEMI who were undergoing primary PCI. The relationship between the LMR48h and all-cause mortality (30-day and long-term) was analyzed by categorizing the patients into tertiles (T) according to LMR48h-T1 (>2.46), T2 (1.67-2.46), and T3 (<1.67). The T3 group exhibited the highest risk of 30-day all-cause mortality (hazard ratio [HR]: 8.093 [1.006-65.074]; P = .049). For long-term mortality, a significantly higher mortality risk was observed in both T2 (HR: 2.005 [1.021-3.939]; P = .043) and T3 groups (HR: 2.374 [1.160-4.857]; P < .001) compared to the T1 group (reference group). In multivariate analysis, these associations remained unaltered even after adjusting for confounders. A low LMR at 48 hours after admission may be independently associated with both 30-day and long-term mortality in patients with STEMI who were treated with primary PCI. This marker may be used for identifying patients with STEMI at high risk.
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Affiliation(s)
- Tuncay Kiris
- 1 Department of Cardiology, Ataturk Training and Research Hospital, Medical School, Izmir Katip Celebi University, Izmir Turkey
| | - Aykan Çelik
- 1 Department of Cardiology, Ataturk Training and Research Hospital, Medical School, Izmir Katip Celebi University, Izmir Turkey
| | - Eser Variş
- 1 Department of Cardiology, Ataturk Training and Research Hospital, Medical School, Izmir Katip Celebi University, Izmir Turkey
| | - Erol Akan
- 1 Department of Cardiology, Ataturk Training and Research Hospital, Medical School, Izmir Katip Celebi University, Izmir Turkey
| | - Zehra Ilke Akyildiz
- 1 Department of Cardiology, Ataturk Training and Research Hospital, Medical School, Izmir Katip Celebi University, Izmir Turkey
| | - Mustafa Karaca
- 1 Department of Cardiology, Ataturk Training and Research Hospital, Medical School, Izmir Katip Celebi University, Izmir Turkey
| | - Cem Nazli
- 1 Department of Cardiology, Ataturk Training and Research Hospital, Medical School, Izmir Katip Celebi University, Izmir Turkey
| | - Abdullah Dogan
- 1 Department of Cardiology, Ataturk Training and Research Hospital, Medical School, Izmir Katip Celebi University, Izmir Turkey
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Zhou D, Wang G, Fan Y, Wan Z, Liu X. Platelet to lymphocyte ratio is associated with the severity of coronary artery disease and clinical outcomes of percutaneous coronary intervention in the Chinese Han population. Exp Ther Med 2016; 13:731-738. [PMID: 28352359 DOI: 10.3892/etm.2016.3993] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 08/23/2016] [Indexed: 01/02/2023] Open
Abstract
The aim of the present study was to evaluate whether the ratio of the absolute number of platelets to the number of lymphocytes (PLR) correlates with the severity of coronary artery disease (CAD) and major adverse cardiovascular disease (CVD) events in Chinese patients with CAD. PLR was calculated as follows: PLR=platelet count/lymphocyte count, using the complete blood counts of 854 Chinese Han subjects. CAD severity was determined using angiographic evidence by cardiologists unaware of the study aims. The association between PLR and CAD severity was analyzed by logistic regression. Clinical endpoints were evaluated during a median follow-up period of 42 months. The association between PLR and CVD events was assessed using Cox regression models. Patients with PLR>171 exhibited more severe coronary artery stenosis [odds ratio, 2.393; 95% confidence intervals (CI), 1.394-4.108; P=0.002] and worse prognoses, with a higher rate of major adverse CVD events during five years of follow-up (hazard ratio, 1.982; 95% CI, 1.329-2.957; P=0.001). A Kaplan-Meier curve demonstrated that the CVD event rate of 34.27% in patients with PLR>171 was significantly higher than that in patients with PLR<100 (P<0.001). These findings suggest that PLR is independently associated with CAD severity and long-term major adverse CVD events; therefore, high PLR may predict poor prognosis of CAD in the Chinese Han population.
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Affiliation(s)
- Dong Zhou
- Department of Cardiovascular Medicine, Hanzhong Central Hospital, Hanzhong, Shaanxi 723000, P.R. China; Department of Cardiovascular Medicine, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Guangyao Wang
- Department of Cardiovascular Medicine, Guangxi Zhuang Autonomous Region Brain Hospital, Liuzhou, Guangxi 545005, P.R. China
| | - Yan Fan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Zhaofei Wan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
| | - Xiaojun Liu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China
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The Combined Usefulness of the Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Predicting Intravenous Immunoglobulin Resistance with Kawasaki Disease. J Pediatr 2016; 178:281-284.e1. [PMID: 27526622 DOI: 10.1016/j.jpeds.2016.07.035] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 06/24/2016] [Accepted: 07/25/2016] [Indexed: 12/21/2022]
Abstract
The laboratory records of 405 patients with Kawasaki disease before and after intravenous immunoglobulin (IVIG) therapy were compared between the IVIG-responsive (n = 320) and IVIG-resistant (n = 85) groups. A high neutrophil-to-lymphocyte ratio and a high platelet-to-lymphocyte ratio before IVIG, especially when combined, were useful predictors for IVIG resistance in Kawasaki disease.
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41
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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.
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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
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Küçük E, Kocayiğit İ, Günel C, Düzenli H. Neutrophil-to-lymphocyte ratio in occlusive vascular diseases: the literature review of the past 10 years. World J Emerg Med 2016; 7:165-72. [PMID: 27547274 DOI: 10.5847/wjem.j.1920-8642.2016.03.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study aims to evaluate the results of studies investigating neutrophil-to-lymphocyte ratio (NLR) and to identify the prognostic and diagnostic value of NLR in occlusive vascular diseases. METHODS With the aim of identifying the studies related to NLR, a search was performed on http://www.ncbi.nlm.nih.gov/pubmed by using the key words "neutrophil lymphocyte ratio" between January 2005 and December 2014. All of the original articles were evaluated according to date of publications, countries, clinics and topics. Studies about occlusive vascular diseases were evaluated according to their qualifications, review methods and results. SPSS for Windows 16.0 was used in data analysis and data were expressed as mean, standard deviation and percentage. RESULTS A total of 735 original research articles were investigated. The number of publications have shown a regular logarithmic increase over the years. Thirty-two percent of all publications were performed by clinics in Turkey and 56.4% were performed by general-oncological surgery and cardiology clinics. A total of 107 publications were identified to be about occlusive vascular diseases, 80.3% of these publications were found to be prognostic and 19.6% to be diagnostic, 82.2% of them were found to be planned as retrospective and 17.7% as prospective. In 95.3% of prognostic publications, there was a positive correlation between high NLR values at admission and poor prognosis. In 95.3% of diagnostic publications high NLR values at admission were identified to be significant diagnostically. CONCLUSION Elevated neutrophil-to-lymphocyte ratio at admission, could be used as a diagnostic and/or prognostic parameter in occlusive vascular diseases.
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Affiliation(s)
- Egemen Küçük
- Department of Emergency Medicine, Training and Research Hospital, Sakarya University, Sakarya 54000, Turkey
| | - İbrahim Kocayiğit
- Department of Cardiology, Training and Research Hospital, Sakarya University, Sakarya 54000, Turkey
| | - Candan Günel
- Department of Anaesthesiology, Training and Research Hospital, Sakarya University, Sakarya 54000, Turkey
| | - Hasan Düzenli
- Department of Chest Diseases, Training and Research Hospital, Sakarya University, Sakarya 54000, Turkey
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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.
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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
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Sun XP, Li J, Zhu WW, Li DB, Chen H, Li HW, Chen WM, Hua Q. Impact of Platelet-to-Lymphocyte Ratio on Clinical Outcomes in Patients With ST-Segment Elevation Myocardial Infarction. Angiology 2016; 68:346-353. [PMID: 27381032 DOI: 10.1177/0003319716657258] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
We investigated the association between platelet-to-lymphocyte ratio (PLR) and clinical outcomes (including all-cause mortality, recurrent myocardial infarction, heart failure, serious cardiac arrhythmias and ischemic stroke) in patients with ST-segment elevation myocardial infarction (STEMI). Based on PLR quartiles, 5886 patients with STEMI were categorized into 4 groups: <98.8 (n = 1470), 98.8 to 125.9 (n = 1474), 126.0 to 163.3 (n = 1478), >163.3 (n = 1464), respectively. We used Cox proportional hazards models to examine the relation between PLR and clinical outcomes. Mean duration of follow-up was 81.6 months, and 948 patients (16.1%) died during follow-up. The lowest mortality occurred in the lowest PLR quartile group ( P = 0.006), with an adjusted hazard ratio of 1.18 (95% confidence interval [CI], 1.04-1.55), 1.31 (95% CI, 1.18-1.64), and 1.59 (95% CI, 1.33-1.94) in patients with PLR of 98.8 to 125.9, 126.0 to 163.3, >163.3, respectively. Higher levels of PLR were also associated with recurrent myocardial infarction ( Ptrend = .023), heart failure ( Ptrend = .018), and ischemic stroke ( Ptrend = .043). In conclusion, a higher PLR was associated with recurrent myocardial infarction, heart failure, ischemic stroke, and all-cause mortality in patients with STEMI.
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Affiliation(s)
- Xi-Peng Sun
- 1 Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jing Li
- 1 Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Wei-Wei Zhu
- 1 Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Dong-Bao Li
- 2 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hui Chen
- 2 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hong-Wei Li
- 2 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wen-Ming Chen
- 3 Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Qi Hua
- 1 Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China
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Balta S, Celik T, Mikhailidis DP, Ozturk C, Demirkol S, Aparci M, Iyisoy A. The Relation Between Atherosclerosis and the Neutrophil–Lymphocyte Ratio. Clin Appl Thromb Hemost 2016; 22:405-411. [DOI: 10.1177/1076029615569568] [Citation(s) in RCA: 229] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Inflammation plays an important role in the pathophysiology of vascular disease. In this review, we consider the associations between the neutrophil–lymphocyte ratio (NLR; an indicator of inflammation) and vascular disease and its associated risk factors. The NLR has received attention due to its role as an independent prognostic factor for coronary artery disease. The NLR can also be affected by atherosclerotic risk factors, such as hypercholesterolemia, metabolic syndrome, diabetes, and hypertension. Importantly, it can predict mortality in cardiovascular diseases. There are also reports of a positive correlation between the NLR and commonly used inflammatory markers. Inflammation is important not only in pathophysiology but also clinical outcomes of many diseases. The NLR is a widely available, easily derived, and reproducible marker of inflammation. Unlike many other inflammatory markers, the NLR is inexpensive and readily available and it provides additional risk stratification beyond conventional risk scores.
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Affiliation(s)
- Sevket Balta
- Department of Cardiology, Eskisehir Military Hospital, Eskişehir, Turkey
| | - Turgay Celik
- Department of Cardiology, Gulhane Medical Academy, Ankara, Turkey
| | - Dimitri P. Mikhailidis
- Department of Clinical Biochemistry, University College London Medical School London, University College London (UCL), London, England
| | - Cengiz Ozturk
- Department of Cardiology, Gulhane Medical Academy, Ankara, Turkey
| | - Sait Demirkol
- Department of Cardiology, Gulhane Medical Academy, Ankara, Turkey
| | - Mustafa Aparci
- Department of Cardiology, Etimesgut Military Hospital, Ankara, Turkey
| | - Atila Iyisoy
- Department of Cardiology, Gulhane Medical Academy, Ankara, Turkey
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46
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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]
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47
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Çiçek G, Yayla Ç, Açıkgoz SK. Predictive Value of Combination of NLR and PLR in the Absence of Medical Treatment. Angiology 2015; 67:197. [PMID: 26251052 DOI: 10.1177/0003319715599283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Gökhan Çiçek
- Department of Cardiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Çağrı Yayla
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Sadık Kadri Açıkgoz
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
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48
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Çiçek G, Yayla Ç, Açıkgoz SK. PLR Study Participants Lack the Risk Factors for the Rare Entity Called EDTA-Dependent Pseudothrombocytopenia. Angiology 2015. [PMID: 26198470 DOI: 10.1177/0003319715596414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Gökhan Çiçek
- Department of Cardiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Çağrı Yayla
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Sadık Kadri Açıkgoz
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
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49
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Eyüboğlu M. Predictive Value of Combination of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio for Prognosis. Angiology 2015; 67:195. [PMID: 26124492 DOI: 10.1177/0003319715593224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Mehmet Eyüboğlu
- Department of Cardiology, Special Izmir Europe Medicine Center, Karabaglar, Izmir, Turkey
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50
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Uslu AU, Inal S, Balta S. Assessment of Platelet-Lymphocyte Ratio Based on EDTA-Dependent Pseudothrombocytopenia. Angiology 2015; 67:96-7. [PMID: 26124494 DOI: 10.1177/0003319715591331] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Ali Ugur Uslu
- Department of Internal Medicine, Eskisehir Military Hospital, Eskisehir, Turkey
| | - Satılmıs Inal
- Department of Internal Medicine, Eskisehir Military Hospital, Eskisehir, Turkey
| | - Sevket Balta
- Department of Cardiology, Eskisehir Military Hospital, Eskisehir, Turkey
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