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Zhu Q, Wang S, Huang X, Zhao C, Wang Y, Li X, Jia D, Ma C. Understanding the pathogenesis of coronary slow flow: Recent advances. Trends Cardiovasc Med 2024; 34:137-144. [PMID: 36516963 DOI: 10.1016/j.tcm.2022.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 11/24/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
Coronary slow flow is taken to be indicative of delayed filling of terminal vessels of the coronary arteries in the absence of coronary stenosis, as detected using coronary angiography. Patients suffering from coronary slow flow typically experience recurrent chest pain, thereby markedly affecting their quality of life. The etiology and pathogenesis of coronary slow flow, which is gradually attracting clinical attention, have yet to be sufficiently established, although it is currently believed that they may be associated with endothelial dysfunction in the coronary arteries, inflammatory response, abnormalities in microvascular reserve function, subclinical atherosclerosis, blood cell and platelet abnormalities, and genetic factors. In this review, we provide a brief overview of recent progress in research on the pathogenesis of coronary slow flow with a view toward elucidating the possible underlying pathogenesis and identify targets and directions for the treatment of this condition.
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Affiliation(s)
- Qing Zhu
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China; Clinical Medical Research Center of Imaging in Liaoning Province, Shenyang, China
| | - Shitong Wang
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China; Clinical Medical Research Center of Imaging in Liaoning Province, Shenyang, China
| | - Xin Huang
- Department of Radiology, The First Hospital of China Medical University, Shenyang, China
| | - Cuiting Zhao
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China; Clinical Medical Research Center of Imaging in Liaoning Province, Shenyang, China
| | - Yonghuai Wang
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China; Clinical Medical Research Center of Imaging in Liaoning Province, Shenyang, China
| | - Xinxin Li
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China; Clinical Medical Research Center of Imaging in Liaoning Province, Shenyang, China
| | - Dalin Jia
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, China
| | - Chunyan Ma
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China; Clinical Medical Research Center of Imaging in Liaoning Province, Shenyang, China.
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Chakrala T, Prakash R, Valdes C, Pepine CJ, Keeley EC. Circulating Biomarkers in Coronary Microvascular Dysfunction. J Am Heart Assoc 2023:e029341. [PMID: 37301749 DOI: 10.1161/jaha.122.029341] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Coronary microvascular dysfunction is an underdiagnosed pathologic process that is associated with adverse clinical outcomes. Biomarkers, molecules measurable in the blood, could inform the clinician by aiding in the diagnosis and management of coronary microvascular dysfunction. We present an updated review of circulating biomarkers in coronary microvascular dysfunction representing key pathologic processes, including inflammation, endothelial dysfunction, oxidative stress, coagulation, and other mechanisms.
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Affiliation(s)
- Teja Chakrala
- Department of Medicine University of Florida Gainesville FL USA
| | - Roshni Prakash
- Department of Medicine University of Florida Gainesville FL USA
| | - Carlos Valdes
- Department of Medicine University of Florida Gainesville FL USA
| | - Carl J Pepine
- Department of Medicine University of Florida Gainesville FL USA
- Division of Cardiovascular Medicine University of Florida Gainesville FL USA
| | - Ellen C Keeley
- Department of Medicine University of Florida Gainesville FL USA
- Division of Cardiovascular Medicine University of Florida Gainesville FL USA
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Dai XT, Kong TZ, Zhang XJ, Luan B, Wang Y, Hou AJ. Relationship between increased systemic immune-inflammation index and coronary slow flow phenomenon. BMC Cardiovasc Disord 2022; 22:362. [PMID: 35941535 PMCID: PMC9358856 DOI: 10.1186/s12872-022-02798-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
Background Systemic immune-inflammation index (SII, platelet × neutrophil/lymphocyte ratio), a new marker of inflammation, is associated with adverse cardiovascular events, but its relationship with coronary slow flow phenomenon (CSFP) is unclear. Therefore, we aimed to investigate the relationship between SII and CSFP. Methods We enrolled consecutive patients who presented with chest pain, with normal/near-normal coronary angiography findings (n = 89 as CSFP group; n = 167 as control group). The baseline characteristics, laboratory parameters and angiographic characteristics of the two groups were compared. Results SII levels were significantly higher in the CSFP group than in the control group (409.7 ± 17.7 vs. 396.7 ± 12.7, p < 0.001). A significant positive correlation between SII and the mean thrombolysis in myocardial infarction frame count (mTFC) was found (r = 0.624, p < 0.001). SII increased with the number of coronary arteries involved in CSFP. In multivariate logistic regression analysis, SII/10 was an independent predictor of CSFP (odds ratio: 1.739, p < 0.001). In addition, the SII level > 404.29 was a predictor of CSFP with 67.4% sensitivity and 71.9% specificity. Conclusions SII can predict the occurrence of CSFP.
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Affiliation(s)
- Xin-Tong Dai
- Department of Cardiology, The People' S Hospital of China Medical University, The People' S Hospital of Liaoning Province, No. 33, Wenyi Road, Shenhe District, Shenyang City, Liaoning Province, China
| | - Tian-Zhong Kong
- Department of Cardiology, The People' S Hospital of China Medical University, The People' S Hospital of Liaoning Province, No. 33, Wenyi Road, Shenhe District, Shenyang City, Liaoning Province, China
| | - Xiao-Jiao Zhang
- Department of Cardiology, The People' S Hospital of China Medical University, The People' S Hospital of Liaoning Province, No. 33, Wenyi Road, Shenhe District, Shenyang City, Liaoning Province, China
| | - Bo Luan
- Department of Cardiology, The People' S Hospital of China Medical University, The People' S Hospital of Liaoning Province, No. 33, Wenyi Road, Shenhe District, Shenyang City, Liaoning Province, China
| | - Yong Wang
- Department of Cardiology, The People' S Hospital of China Medical University, The People' S Hospital of Liaoning Province, No. 33, Wenyi Road, Shenhe District, Shenyang City, Liaoning Province, China.
| | - Ai-Jie Hou
- Department of Cardiology, The People' S Hospital of China Medical University, The People' S Hospital of Liaoning Province, No. 33, Wenyi Road, Shenhe District, Shenyang City, Liaoning Province, China.
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Yilmaz SK, Özçiçek F. Comparison of inflammation-related hematologic indices for predicting metabolic syndrome in adults. Int J Diabetes Dev Ctries 2022. [DOI: 10.1007/s13410-022-01093-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Assessment of anti-desmoglein antibodies levels and other laboratory indexes as objective comprehensive indicators of patients with pemphigus vulgaris of different severity: a single-center retrospective study. Clin Exp Med 2022; 23:511-518. [PMID: 35445951 DOI: 10.1007/s10238-022-00823-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/17/2022] [Indexed: 11/27/2022]
Abstract
The aim of this study is to assess the utility of anti-desmoglein (Dsg) antibodies levels, hematological biomarkers levels, the albumin to globulin (A/G) ratio, blood lipids levels, and lymphocyte subpopulation percentages as objective laboratory indicators of disease severity of pemphigus vulgaris (PV). A retrospective study of 187 PV patients with 256 medical records between January 2013 and December 2020. PV patients were divided into three groups by disease severity according to the pemphigus disease area index (PDAI) score: mild (0-8), moderate (9-24), and severe (≥ 25). The levels of anti-Dsg antibodies, hematological biomarkers, A/G ratio, blood lipids, and the percentage of lymphocyte subpopulations were measured. We assessed the correlations of quantitative variables by Pearson correlation (r). Multivariable linear regression was used to identify the variables associated with the disease severity of PV (PDAI score). The results show that the levels of Dsg1 (r = 0.294, P < 0.001) and Dsg3 (r = 0.206, P = 0.011), monocyte count (r = 0.210, P = 0.001), neutrophil-to-lymphocyte ratio (NLR) (r = 0.123, P = 0.049), and platelet-to-lymphocyte ratio (PLR) (r = 0.170, P = 0.006) were positively correlated with the PDAI score. However, the A/G ratio (r = - 0.399, P < 0.001), and the levels of total serum cholesterol (r = - 0.140, P = 0.026) and HDL (r = - 0.143, P = 0.023) were negatively correlated with the PDAI score. Multiple linear regression showed that the factors associated with the PDAI score were higher level of anti-Dsg1 antibody (P = 0.001), a higher NLR (P = 0.005), and a lower A/G ratio (P < 0.001). The linear regression equation was Y(PDAI) = 32.798 + 0.058X(Dsg1) + 0.846 X(NLR)-16.472 X(A/G) (R2 = 0.586). Therefore, high levels of anti-Dsg1 antibody and NLR combined with a low A/G ratio could explain the PDAI score. These findings might provide a more comprehensive and objective evaluation system for reflecting the disease severity of PV based on laboratory indicators.
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ÖZMEN Ç, AKRAY A, İLTAŞ A, ÖZMEN YILDIZ P, YILDIZ İ, AKTAŞ H. Primer perkütan koroner girişim uygulanan ST-segment yükseklikli miyokard infarktüslü hastalarda platelet/lenfosit oranı ile no-reflow oluşumu arasındaki ilişki. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.977656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Akboga MK, Inanc IH. Plasma Leukocyte Cell-Derived Chemotaxin 2 for the Severity of Coronary Artery Disease. Angiology 2021; 73:281-282. [PMID: 34634211 DOI: 10.1177/00033197211047326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Mehmet Kadri Akboga
- Department of Cardiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ibrahim Halil Inanc
- Department of Cardiology, Kırıkkale Yuksek Ihtisas Hospital, Kırıkkale, Turkey
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Chalikias G, Tziakas D. Slow Coronary Flow: Pathophysiology, Clinical Implications, and Therapeutic Management. Angiology 2021; 72:808-818. [PMID: 33779300 DOI: 10.1177/00033197211004390] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Coronary slow flow (CSF) is an angiographic phenomenon with specific epidemiologic characteristics, associated clinical presentation, and prognosis. Although patients with CSF are diagnosed as having "normal coronary arteries," it seems appropriate to consider CSF as a distinct disease entity requiring specific treatment. The patient with CSF is usually male, smoker, obese, with a constellation of risk factors suggestive of metabolic syndrome. Unstable angina is the most common clinical presentation, with recurrent episodes of chest pain at rest associated with electrocardiographic changes often requiring readmission and reevaluation. Regarding definition and diagnosis, interventionists should first exclude possible "secondary" causes of CSF, use objective means for definition and then differentiate from other similar conditions such as microvascular angina. Although the phenomenon is generally benign, patients with CSF are severely symptomatic with recurrent episodes of chest pain and poor quality of life. Furthermore, acute presentation of the phenomenon is commonly life-threatening with ventricular tachyarrhythmias, conduction abnormalities, or cardiogenic shock. Acute treatment of CSF includes, but is not restricted to, intracoronary infusion of dipyridamole, adenosine, or atropine. Chronic management of patients with CSF encompasses dipyridamole, diltiazem, nebivolol, telmisartan, and/or atorvastatin associated with amelioration of angina symptoms, improved quality of life, and good prognosis.
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Affiliation(s)
- George Chalikias
- Cardiology Department, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Dimitrios Tziakas
- Cardiology Department, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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Yu S, Guo X, Li G, Yang H, Zheng L, Sun Y. Lymphocyte to High-Density Lipoprotein Ratio but Not Platelet to Lymphocyte Ratio Effectively Predicts Metabolic Syndrome Among Subjects From Rural China. Front Cardiovasc Med 2021; 8:583320. [PMID: 33778016 PMCID: PMC7994280 DOI: 10.3389/fcvm.2021.583320] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/03/2021] [Indexed: 12/26/2022] Open
Abstract
Background: This study intended to use two novel inflammatory indicators: lymphocyte to high-density lipoprotein cholesterol ratio (LHR) and platelet to lymphocyte ratio (PLR), to predict newly diagnosed metabolic syndrome (MetS) among subjects from rural Northeast China. Methods: Adult participants without MetS at baseline (n = 4,980, age = 52.65 ± 10.21 years; 51.9% men) were originated from the Northeast China Rural Cardiovascular Health Study (NCRCHS). LHR (Q1: ≤1.04; Q2: 1.04–1.35; Q3: 1.35–1.79; Q4: ≥1.79) and PLR (Q1: ≤78.50; Q2: 78.50–107.27; Q3: 107.27–140.00; Q4: ≥140.00) were divided in quartile. Results: After 4.66-year follow-up, 1,194 subjects were diagnosed MetS (cumulative incidence 24.0; 25.8% for female and 22.3% for male, P = 0.002). Newly diagnosed MetS had higher value of hemoglobin and platelet count compared to those without MetS. As for LHR, from Q1 to Q4, there were increasing value of waist circumference (WC), serum triglycerides (TG), rates of current smoking and drinking whereas decreasing value of HDL-C. However, for PLR, rates of current smoking and drinking significantly decreased from Q1 to Q4. Similarly, the value of WC and TG showed a decreasing trend. In a logistic regression analysis, after adjusted for possible confounders, LHR [OR (95% CI) Q2: 1.13 (0.86, 1.48); OR (95% CI) Q3: 1.23 (0.94, 1.61); OR (95% CI) Q4: 1.57(1.20, 2.06)] but not PLR was effective predictor of newly diagnosed MetS among rural Chinese. Conclusion: MetS had closed relationship with inflammation among subjects from rural China. As a novel marker of inflammation, LHR but not PLR might be an effective predictor of newly diagnosed MetS and should be widely used in the epidemiological study.
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Affiliation(s)
- Shasha Yu
- Department of Cardiology, First Hospital of China Medical University, Shenyang, China
| | - Xiaofan Guo
- Department of Cardiology, First Hospital of China Medical University, Shenyang, China
| | - GuangXiao Li
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases, First Hospital of China Medical University, Shenyang, China
| | - Hongmei Yang
- Department of Cardiology, First Hospital of China Medical University, Shenyang, China
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yingxian Sun
- Department of Cardiology, First Hospital of China Medical University, Shenyang, China
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El Missiri A, Awad M, Shaheen S. The relation between platelet/lymphocyte ratio and the occurrence of no reflow in patients with ST-segment elevation myocardial infarction managed by primary percutaneous coronary intervention. INTERNATIONAL JOURNAL OF THE CARDIOVASCULAR ACADEMY 2021. [DOI: 10.4103/ijca.ijca_52_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Nowroozpoor A, Gutterman D, Safdar B. Is microvascular dysfunction a systemic disorder with common biomarkers found in the heart, brain, and kidneys? - A scoping review. Microvasc Res 2020; 134:104123. [PMID: 33333140 DOI: 10.1016/j.mvr.2020.104123] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/09/2020] [Accepted: 12/12/2020] [Indexed: 02/07/2023]
Abstract
Although microvascular dysfunction (MVD) has been well characterized in individual organs as different disease entities, clinical evidence is mounting in support of an underlying systemic process. To address this hypothesis, we systematically searched PubMed and Medline for studies in adults published between 2014 and 2019 that measured blood biomarkers of MVD in three vital organs i.e. brain, heart, and the kidney. Of the 9706 unique articles 321 met the criteria, reporting 49 biomarkers of which 16 were common to the three organs. Endothelial dysfunction, inflammation including reactive oxidation, immune activation, and coagulation were the commonly recognized pathways. Triglyceride, C-reactive protein, Cystatin C, homocysteine, uric acid, IL-6, NT-proBNP, thrombomodulin, von Willebrand Factor, and uric acid were increased in MVD of all three organs. In contrast, vitamin D was decreased. Adiponectin, asymmetric dimethylarginine, total cholesterol, high-density and low-density cholesterol were found to be variably increased or decreased in studies. We review the pathways underlying MVD in the three organs and summarize evidence supporting its systemic nature. This scoping review informs clinicians and researchers in the multi-system manifestation of MVD. Future work should focus on longitudinal investigations to evaluate the multi-system involvement of this disease.
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Affiliation(s)
- Armin Nowroozpoor
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States
| | - David Gutterman
- Department of Internal Medicine, Section of Cardiology, Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Basmah Safdar
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States.
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Qiu Z, Jiang Y, Jiang X, Yang R, Wu Y, Xu Y, Cheng X. Relationship Between Platelet to Lymphocyte Ratio and Stable Coronary Artery Disease: Meta-Analysis of Observational Studies. Angiology 2020; 71:909-915. [PMID: 32720814 DOI: 10.1177/0003319720943810] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Recent studies have reported a relationship between the platelet to lymphocyte ratio (PLR) and acute coronary syndromes. The aim of the present study was to investigate the association between PLR and stable coronary artery disease (CAD). A systematic search was conducted based on electronic databases (Cochrane, PubMed, Elsevier, Medline, and Embase). A total of 14 studies (n = 4,871) were included in the meta-analysis. Compared with the non-CAD group, PLR was significantly higher in CAD group (P = .002). After further classification according to the Gensini score, the cases with atherosclerosis demonstrated a higher PLR than those without atherosclerosis (P < .001). Platelet to lymphocyte ratio was higher in the severe atherosclerosis group compared with the mild atherosclerosis group (P < .001). Compared with the poor coronary collateral circulation (CCC) group, PLR was significantly lower in the good CCC group (P < .001). The PLR was significantly higher in patients with coronary slow flow (CSF) than those with normal coronary flow (P = .01). On the basis of current evidence, an elevated PLR was associated with stable CAD, and it might be useful for predicting CAD severe stenosis, collateral circulation, and CSF. Future studies are needed to clarify the relationship between PLR and stable CAD.
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Affiliation(s)
- Zhiqiang Qiu
- Department of Orthopedics, 47861Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Yu Jiang
- Department of Cardiovascular Medicine, 47861Second Affiliated Hospital of Nanchang University, Institute of Cardiovascular Disease, Nanchang, Jiangxi, People's Republic of China
| | - Xinghua Jiang
- Department of Cardiovascular Medicine, 47861Second Affiliated Hospital of Nanchang University, Institute of Cardiovascular Disease, Nanchang, Jiangxi, People's Republic of China
| | - Renqiang Yang
- Department of Cardiovascular Medicine, 47861Second Affiliated Hospital of Nanchang University, Institute of Cardiovascular Disease, Nanchang, Jiangxi, People's Republic of China
| | - Yanqing Wu
- Department of Cardiovascular Medicine, 47861Second Affiliated Hospital of Nanchang University, Institute of Cardiovascular Disease, Nanchang, Jiangxi, People's Republic of China
| | - Yan Xu
- Department of Cardiovascular Medicine, 47861Second Affiliated Hospital of Nanchang University, Institute of Cardiovascular Disease, Nanchang, Jiangxi, People's Republic of China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, 47861Second Affiliated Hospital of Nanchang University, Institute of Cardiovascular Disease, Nanchang, Jiangxi, People's Republic of China
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Liang B, Li M, Deng Q, Wang C, Rong J, He S, Xiang Y, Zheng F. CircRNA ZNF609 in peripheral blood leukocytes acts as a protective factor and a potential biomarker for coronary artery disease. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:741. [PMID: 32647666 PMCID: PMC7333115 DOI: 10.21037/atm-19-4728] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background Circular RNAs (circRNAs) have been reported to aberrantly express in coronary artery disease (CAD). Due to their special structures, circRNAs have the potential to be specific and stable markers. We conducted this study to explore circZNF609's function in atherosclerosis and to evaluate its predictive values for CAD. Methods About 330 CAD patients and 209 controls were enrolled and the expression of circZNF609 in peripheral blood leukocytes (PBLs) was detected by quantitative real time polymerase chain reaction (RT-PCR). Spearman correlation, multivariate regression, multivariate logistic regression and receiver operating characteristic curve (ROC) were performed. Moreover, circZNF609 was overexpressed in mice macrophage RAW264.7 to investigate its influence on inflammatory cytokines. Finally, bioinformatics analysis was executed to excavate the potential downstream pathway of circZNF609. Results The expression level of circZNF609 in PBLs of CAD patients was significantly decreased compared with the controls (the fold changes of 0.4133, P<0.0001). The logistic regression analysis showed that decreased circZNF609 expressions were independently associated with increased risks of CAD. The area under the ROC curve was 0.761 (95% CI: 0.721-0.800, P<0.0001). Furthermore, the circZNF609 expression level was correlated with C-reactive protein (r=-0.138, P=0.026) and lymphocyte counts (r=0.16, P=0.01). After overexpression of circZNF609 in RAW264.7 cells, the expression level of IL-6 (P<0.001) and TNF-α (P<0.01) were significantly decreased and IL-10 was significantly increased (P<0.001). Bioinformatics analysis suggested that the abnormal expression of circZNF609 might probably sponge miRNA to modulate the inflammation cytokines. Conclusions CircRNA ZNF609 played an anti-inflammatory role and was an independent protective factor for CAD. It represented a moderate diagnostic value and might provide a new therapeutic target for CAD.
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Affiliation(s)
- Bin Liang
- Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Menglan Li
- Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China.,Department of Clinical Laboratory, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Qianyun Deng
- Department of Clinical Laboratory, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Chen Wang
- Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jialing Rong
- Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Siying He
- Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yang Xiang
- Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Fang Zheng
- Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China
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Ding YD, Pei YQ, Wang R, Yang JX, Zhao YX, Liu XL, Shen H, Ma Q, Zhang S, Ge HL. Increased plasma lipoprotein-associated phospholipase A2 levels are associated with coronary slow flow. BMC Cardiovasc Disord 2020; 20:248. [PMID: 32460702 PMCID: PMC7251718 DOI: 10.1186/s12872-020-01463-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/02/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Coronary slow flow (CSF) is characterized by delayed opacification of distal epicardial coronary arteries without significant coronary stenosis. In addition, The changes of lipoprotein-associated phospholipase A2 (Lp-PLA2) as a significant predictive factor for CSF remain controversial. The study aims to investigate the association between plasma Lp-PLA2 and CSF. METHODS In this retrospective study, 170 consecutive patients who underwent coronary angiography were enrolled in Beijing Anzhen Hospital from January 2017 to September 2019, and were divided into CSF group and normal control groups. According to coronary blood flow rate measured by the thrombolysis in myocardial infarction frame count (TFC) method, CSF was defined as TFC > 27. Serum Lp-PLA2 levels were measured in an enzyme-linked immunosorbent assay. RESULTS Lp-PLA2 levels were higher in the CSF group than in the control group (288.6 ± 50.3 versus 141.9 ± 49.7, P < 0.001) and were significantly correlated with the mean coronary artery thrombolysis in myocardial infarction (TIMI) frame count (r = 0.790, P<0.001). Logistic regression analysis showed that high Lp-PLA2 was independently associated with CSF after adjustment for conventional risk factors (OR = 1.040, CI = 1.022-1.059, P<0.001). Male sex (OR = 2.192, CI = 1.161-4.140, P = 0.016) and hypertension (OR = 1.965, CI = 1.034-3.736, P = 0.039) were also CSF risk factors. Receiver-operating characteristic curve (ROC) analysis showed that Lp-PLA2 levels can predict CSF severity; the predictive power was higher than the other risk factors. CONCLUSION Our study demonstrated that patients with CSF had higher circulating levels of Lp-PLA2 than normal controls. After adjustment for potential confounders, increased Lp-PLA2 was independently associated with presence of CSF.
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Affiliation(s)
- Yao-Dong Ding
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, PR China
| | - Yu-Qiang Pei
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, PR China
| | - Rui Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, PR China
| | - Jia-Xing Yang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, PR China
| | - Yin-Xin Zhao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, PR China
| | - Xiao-Li Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, PR China
| | - Hua Shen
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, PR China
| | - Qian Ma
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, PR China
| | - Shuo Zhang
- Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hai-Long Ge
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, PR China.
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An investigation of platelet parameters in smoking patients with coronary slow flow detected during coronary angiography. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.722658] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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COSANSU K, UREYEN CM, KILIC H, KARADAG B, CABBAR A, GUNDUZ H, AKDEMİR R. New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study. DICLE MEDICAL JOURNAL 2020. [DOI: 10.5798/dicletip.705814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Predictive Value of the Platelet-to-Lymphocyte Ratio in Cancer Patients Undergoing Transcatheter Aortic Valve Replacement. JACC: CARDIOONCOLOGY 2019; 1:159-169. [PMID: 34396177 PMCID: PMC8352187 DOI: 10.1016/j.jaccao.2019.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/02/2019] [Accepted: 10/07/2019] [Indexed: 01/20/2023]
Abstract
Objectives The purpose of this study is to investigate the predictive value of the platelet-to-lymphocyte ratio (PLR)in cancer patients undergoing transcatheter aortic valve replacement (TAVR). Background The PLR is a promising marker to predict clinical outcomes in various cancer types as well as in cardiovascular disease. Methods Consecutive TAVR patients were enrolled in the study. We stratified patients into 2 groups: cancer and noncancer. Baseline complete blood counts with a differential hemogram were collected before TAVR. The primary outcome was all-cause death within a 3-year follow-up. Results In total, 240 of 1,204 patients (19.9%) had a cancer history. Cancer patients had a significantly higher baseline PLR than noncancer patients (median [interquartile range], 159.8 [109.6 to 244.6] vs. 150.3 [108.7 to 209.0]; p = 0.024). Kaplan-Meier analysis revealed that cancer patients had worse outcomes than noncancer patients (log-rank p < 0.001). Patients who died had a significantly higher baseline PLR than those who survived both in the cancer (p = 0.009) and noncancer (p = 0.027) groups. Multivariable analyses showed that the PLR (by 100 increase) was an independent predictor of adverse outcomes in both cancer (hazard ratio: 1.07; 95% confidence interval: 1.02 to 1.13; p = 0.006) and noncancer (hazard ratio: 1.20; 95% confidence interval: 1.06 to 1.36; p = 0.004). The highest mortality was observed for patients with cancer and increased PLR (above the median) (log-rank p < 0.001). Conclusions Cancer patients undergoing TAVR had a significantly higher PLR than those without cancer. Higher PLR was associated with a worse outcome following TAVR.
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Erdal E, İnanir M. Platelet-to-lymphocyte ratio (PLR) and Plateletcrit (PCT) in young patients with morbid obesity. ACTA ACUST UNITED AC 2019; 65:1182-1187. [PMID: 31618335 DOI: 10.1590/1806-9282.65.9.1182] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 05/18/2019] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To compare the complete blood counts, namely the plateletcrit (PCT) and Platelet-To-Lymphocyte Ratio (PLR) of healthy subjects and those with morbid obesity in the young population. METHODS We included 45 patients with morbid obesity (body mass index -BMI - greater than or equal to 45 kg/m2) and 45 healthy subjects (BMI less than or equal to 25 kg/m2) in our study. Blood samples were obtained from the participants following a 12-hour fasting period. Then we evaluated the levels of hemoglobin (Hb), hematocrit (HCT), red cell distribution width (RDW), mean platelet volume (MPV), white blood cell (WBC), PLR, platelet counts, and PCT in the complete blood count. RESULTS The morbid obesity group had significantly higher platelet counts and PCT values (p<0.001), and PLR values (p=0.033). The value of WBC was also higher in the obese group (p=0.001). MPV was lower in the obesity group but not statistically significant (p=0.815). No significant difference was found between hemoglobin and hematocrit values in these groups; but RDW valuewere higher and statistically significant in the obese group (p=0.001). CONCLUSION PLR or PCT may be more useful as a marker in determining an increased thrombotic state and inflammatory response in morbid obesity.
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Affiliation(s)
- Emrah Erdal
- . Specialist Bolu Abant İzzet Baysal University, Medical Faculty, Department of Cardiology, Bolu, Turkey
| | - Mehmet İnanir
- . Specialist Bolu Abant İzzet Baysal University, Medical Faculty, Department of Cardiology, Bolu, Turkey
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Maimaiti A, Li Y, Wang YT, Yang X, Li XM, Yang YN, Ma YT. Association of platelet-to-lymphocyte count ratio with myocardial reperfusion and major adverse events in patients with acute myocardial infarction: a two-centre retrospective cohort study. BMJ Open 2019; 9:e025628. [PMID: 31537554 PMCID: PMC6756339 DOI: 10.1136/bmjopen-2018-025628] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Insufficient myocardial reperfusion for patients with acute myocardial infarction (AMI) during primary percutaneous coronary intervention (PPCI) has a great influence on prognosis. The aim of this study was to investigate the association of the platelet-to-lymphocyte ratio (PLR) with myocardial reperfusion and in-hospital major adverse cardiac events (MACEs) in patients with AMI undergoing PPCI. DESIGN Retrospective cohort study. SETTING Patients and researchers from two tertiary hospitals. PARTICIPANTS A total of 445 consecutive AMI patients who underwent PPCI between January 2015 and December 2017 were enrolled. Patients were divided into two groups based on the PLR value: patients with PLR values in the third tertile were defined as the high-PLR group (n=150), and those in the lower two tertiles were defined as the low-PLR group (n=295). Explicit criteria for inclusion and exclusion were applied. INTERVENTIONS No interventions. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome measures were defined as cardiovascular death, reinfarction or target vessel revascularisation. Secondary outcome measures were defined as stroke, non-lethal myocardial infarction, ventricular tachycardia/ventricular fibrillation and in-hospital mortality. RESULTS The high-PLR group had insufficient myocardial perfusion (23% vs 13%, p=0.003), greater postprocedural thrombolysis in myocardial infarction flow grade (0-2) (17% vs 10%, p=0.037), greater myocardial blush grade (0-1) (11% vs 4%, p=0.007) and higher B-type natriuretic peptide (BNP) (614±600 vs 316±429, p<0.001) compared with the low-PLR group. Multivariate logistic regression analysis indicated that the independent risk factors for impaired myocardial perfusion were high PLR (OR 1.256, 95% CI 1.003 to 1.579, p=0.056) and high BNP (OR 1.328, 95% CI 1.056 to 1.670, p=0.015). The high-PLR group had significantly more MACEs (43% vs 32%, p=0.029). CONCLUSIONS This study suggested that high PLR and BNP were independent risk factors for insufficient myocardial reperfusion in patients with AMI. Higher PLR was related to advanced heart failure and in-hospital MACEs in patients with AMI undergoing PPCI.
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Affiliation(s)
- Ailifeire Maimaiti
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yang Li
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yong-Tao Wang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xiang Yang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xiao-Mei Li
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yi-Ning Yang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yi-Tong Ma
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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Adeyanju OA, Soetan OA, Olatunji LA. Drospirenone-containing contraceptive exerts positive effects on cardiac uric acid and PAI-1 but not GSK-3: Improved safety profiles in contraception? ACTA ACUST UNITED AC 2019; 26:227-231. [PMID: 31196791 DOI: 10.1016/j.pathophys.2019.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 06/01/2019] [Accepted: 06/05/2019] [Indexed: 11/24/2022]
Abstract
The use of combined oral contraceptives (COC) have been associated with increased risk of adverse cardiovascular events and elevated cardiac and circulating plasminogen activator inhibitor-1 (PAI-1) and glycogen synthase kinase-3 (GSK-3) have been implicated in these events. Contraceptives containing drospirenone, a progestin with anti-androgenic actions may have a positive or neutral effect on cardiac PAI-1 and GSK-3 levels. Studies on the favorable effects of oral contraceptives containing drospirenone when compared with other androgenic contraceptives have not been fully elucidated. We therefore sought to compare the effect of a contraceptive containing ethinyl estradiol and drospirenone (DSP) with a contraceptive containing ethinyl estradiol and levonorgestrel (LVG) on cardiac uric acid (UA), PAI-1, GSK-3 and some hematological parameters. Ten weeks old female Wistar rats were divided into three groups; control (CON), LVG or DSP treated rats. The treatment lasted for 8 weeks. Results showed that LVG and not DSP treatment led to increase in plasma and cardiac tissue UA, plasma and cardiac PAI-1 as well as granulocyte-lymphocyte ratio (GLR) and platelet-lymphocyte ratio (PLR). However, the DSP treatment affected the circulating GSK-3. Taken together, the findings showed that LVG and not DSP affected cardiac UA and PAI-1. These results suggest that COC containing drospirenone appears to have positive effects on cardiac UA and PAI-1 levels but do not affect GSK-3, hence, COC containing drospirenone may be a better and safer means of contraception compared to androgenic contraceptives.
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Affiliation(s)
- Oluwaseun A Adeyanju
- HOPE Cardiometabolic Research Team, Department of Physiology, College of Health Sciences, University of Ilorin, Ilorin, Nigeria; Cardiometabolic Research Unit, Department of Physiology, Afe Babalola University, Ado-Ekiti, Nigeria
| | - Olaniyi A Soetan
- HOPE Cardiometabolic Research Team, Department of Physiology, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
| | - Lawrence A Olatunji
- HOPE Cardiometabolic Research Team, Department of Physiology, College of Health Sciences, University of Ilorin, Ilorin, Nigeria.
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Kurtul A, Ornek E. Platelet to Lymphocyte Ratio in Cardiovascular Diseases: A Systematic Review. Angiology 2019; 70:802-818. [PMID: 31030530 DOI: 10.1177/0003319719845186] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The platelet to lymphocyte ratio (PLR) is an integrated reflection of 2 opposite thrombotic/inflammatory pathways that are easily calculated from a complete blood count. The PLR initially served as a systemic inflammatory biomarker to predict the prognosis of neoplastic diseases. In recent years, the PLR has been used as a prognostic marker in cardiovascular (CV) conditions. In this review, we consider the evidence regarding the association of the PLR with CV disease (CVD) and its possible use as a prognostic marker of CVD. The role of PLR has been investigated in CV conditions in several studies. We assessed clinical trials using PubMed, EMBASE, and Web of Science (up to April 18, 2018) to evaluate the association between PLR and mortality/major adverse cardiac events in these conditions. Most of these studies reported significant relationships between a high PLR and diverse outcomes. In conclusion, we suggest that PLR is a cheap and easily available systemic inflammatory marker that can predict distinct outcomes in different types of CVD.
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Affiliation(s)
- Alparslan Kurtul
- 1 Cardiology Department, Tayfur Ata Sokmen Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Antakya, Turkey
| | - Ender Ornek
- 2 Cardiology Department, Ankara Numune Education and Research Hospital, Health Sciences University, Ankara, Turkey
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22
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Mathur K, Kurbanova N, Qayyum R. Platelet-lymphocyte ratio (PLR) and all-cause mortality in general population: insights from national health and nutrition education survey. Platelets 2019; 30:1036-1041. [PMID: 30759051 DOI: 10.1080/09537104.2019.1571188] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Platelet lymphocyte ratio (PLR) is a novel marker of inflammation that has gained popularity, especially in prognostication of cardiac diseases and malignant conditions. Several studies have examined the relationship between PLR and disease-specific mortality but none has examined this relationship with all-cause mortality in general population. Therefore, we examined the relationship between PLR and all-cause mortality using data from the National Health and Nutrition Examination Survey (NHANES) from the year 1999 to 2010. The role of PLR in predicting all-cause mortality was evaluated using Cox proportional hazards model adjusting for age, race, gender, smoking history, diabetes, hypertension, serum cholesterol, estimated glomerular filtration rate, serum c-reactive protein, and body mass index. Differential effect of age was examined using difference of differences analysis. Of the 27321 individuals, 2581 died during 171223 person-year follow-up. Mean PLR was significantly higher in participants who died than those who were living at the end of follow-up (145.7 vs. 133.0, respectively, p < 0.001). Individuals in the fourth quartile of PLR were at significantly higher risk of mortality than those in the first quartile (HR = 1.26, 95% CI: 1.08-1.47, p = 0.004 and adjusted HR = 1.33, HR, 95% CI: 1.15-1.54, p < 0.001, respectively). When examining the differential effect of age, association between PLR and mortality was seen in the elderly but not in the middle age or younger participants. Elevated PLR is associated with increased all-cause mortality, especially in the elderly. Further studies examining the mechanism through which PLR may increase mortality are needed.
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Affiliation(s)
- Kanupriya Mathur
- Division of Hospital Medicine, Virginia Commonwealth University , Richmond , VA , USA
| | - Nargiza Kurbanova
- Division of Hospital Medicine, Virginia Commonwealth University , Richmond , VA , USA
| | - Rehan Qayyum
- Division of Hospital Medicine, Virginia Commonwealth University , Richmond , VA , USA
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Wang S, Liu H, Wang Q, Cheng Z, Sun S, Zhang Y, Sun X, Wang Z, Ren L. Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Are Effective Predictors of Prognosis in Patients with Acute Mesenteric Arterial Embolism and Thrombosis. Ann Vasc Surg 2018; 49:115-122. [PMID: 29428537 DOI: 10.1016/j.avsg.2018.01.059] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 12/14/2017] [Accepted: 01/29/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been shown to be valuable prognostic markers for a variety of pathological conditions including solid tumors, sepsis, and others. However, the prognostic values of the NLR and PLR in patients with acute mesenteric arterial embolism (AMAE) and acute mesenteric arterial thrombosis (AMAT) have not been elucidated. The aim of this study was to determine the predictive value of the NLR and PLR for poor prognosis in patients with AMAE and AMAT. METHODS A total of 137 patients with AMAE (n = 77) or AMAT (n = 60) were divided into a poor outcome group (cases of intestinal necrosis or death) and a better outcome group (cases without intestinal necrosis who survived successfully), according to prognosis. Neutrophil, platelet, and lymphocyte counts were recorded before pharmacotherapy or surgery. The NLR and PLR were calculated, and logistic regression analysis was performed to test their prognostic values. RESULTS The cutoff values for NLR and PLR were 11.05 and 156.26, respectively. The PLR was linearly associated with the NLR (R = 0.769, P < 0.001). NLR (odds ratio [OR] = 6.835, 95% confidence interval [CI] = 2.282-20.469, P = 0.001), PLR (OR = 4.871, 95% CI = 1.627-14.587, P = 0.005), and coronary heart disease (OR = 3.388, 95% CI = 1.156-9.929, P = 0.026) were found to be independent prognostic factors for the patients. CONCLUSIONS NLR ≥ 11.05, PLR ≥ 156.26, and coronary heart disease were shown to be risk factors for poor prognosis in patients with AMAE and AMAT. According to these factors, patients can be divided into 3 prognostic groups: good, NLR < 11.05 with PLR < 156.26; moderate, NLR < 11.05 with PLR ≥ 156.26 or NLR ≥ 11.05 with PLR < 156.26; and poor, NLR ≥ 11.05 with PLR ≥ 156.26.
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Affiliation(s)
- Shuai Wang
- Department of Experimental Pharmacology and Toxicology, School of Pharmaceutical Science, Jilin University, Changchun, Jilin, China; Department of Vascular Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Han Liu
- Department of Respiration, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Qi Wang
- Department of Vascular Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Zhihua Cheng
- Department of Vascular Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Siqiao Sun
- Department of Vascular Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yang Zhang
- Department of Vascular Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Xiwei Sun
- Department of Vascular Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Zhongying Wang
- Department of Vascular Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Liqun Ren
- Department of Experimental Pharmacology and Toxicology, School of Pharmaceutical Science, Jilin University, Changchun, Jilin, China.
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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: 7] [Impact Index Per Article: 1.0] [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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Gitmez M. Association of novel inflammatory biomarkers with coronary collateral development and SYNTAX score. Int J Cardiol 2017; 229:65. [DOI: 10.1016/j.ijcard.2016.11.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 11/07/2016] [Indexed: 11/28/2022]
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Arjmand N, Dehghani MR. Complete blood cell count components and coronary slow-flow phenomenon. Ther Clin Risk Manag 2016; 12:1827-1829. [PMID: 27980412 PMCID: PMC5144915 DOI: 10.2147/tcrm.s121433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Affiliation(s)
- Nasim Arjmand
- Department of Cardiology, Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Mohammad Reza Dehghani
- Department of Cardiology, Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran
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Edem E, Reyhanoğlu H, Küçükukur M, Kırdök AH, Kınay AO, Tekin Üİ, Özcan K, Ertürk M, Şentürk Ç, Kırılmaz B, Güngör H, Durmaz İ. Predictive value of platelet-to-lymphocyte ratio in severe degenerative aortic valve stenosis. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2016; 21:93. [PMID: 28163739 PMCID: PMC5244652 DOI: 10.4103/1735-1995.192509] [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: 11/19/2015] [Revised: 02/06/2016] [Accepted: 06/12/2016] [Indexed: 11/08/2022]
Abstract
Background: Aortic valve stenosis (AVS) is the most common cause of left ventricular outflow obstruction, and its prevalence among elderly patients causes a major public health burden. Recently, platelet-to-lymphocyte ratio (PLR) has been recognized as a novel prognostic biomarker that offers information about both aggregation and inflammation pathways. Since PLR indicates inflammation, we hypothesized that PLR may be associated with the severity of AVS due to chronic inflammation pathways that cause stiffness and calcification of the aortic valve. Materials and Methods: We retrospectively enrolled 117 patients with severe degenerative AVS, who underwent aortic valve replacement and 117 control patients in our clinic. PLR was defined as the absolute platelet count divided by the absolute lymphocyte count. Severe AVS was defined as calcification and sclerosis of the valve with a mean pressure gradient of >40 mmHg. Results: PLR was 197.03 ± 49.61 in the AVS group and 144.9 ± 40.35 in the control group, which indicated a statistically significant difference (P < 0.001). A receiver operating characteristic (ROC) curve analysis demonstrated that PLR values over 188 predicted the severity of aortic stenosis with a sensitivity of 87% and a specificity of 70% (95% confidence interval = 0.734–0.882; P < 0.001; area under ROC curve: 0.808). Conclusion: We suggest that the level of PLR elevation is related to the severity of degenerative AVS, and PLR should be used to monitor patients' inflammatory responses and the efficacy of treatment, which will lead us to more closely monitor this high-risk population to detect severe degenerative AVS at an early stage.
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Affiliation(s)
- Efe Edem
- Department of Cardiology, Tınaztepe Hospital, Izmir, Turkey
| | - Hasan Reyhanoğlu
- Department of Cardiovascular Surgery, Tınaztepe Hospital, Izmir, Turkey
| | - Murat Küçükukur
- Department of Cardiology, Bergama State Hospital, Bergama, Turkey
| | | | | | | | - Kaan Özcan
- Department of Cardiovascular Surgery, Tınaztepe Hospital, Izmir, Turkey
| | - Murat Ertürk
- Department of Cardiovascular Surgery, Tınaztepe Hospital, Izmir, Turkey
| | - Çağın Şentürk
- Department of Interventional Radiology, Tınaztepe Hospital, Izmir, Turkey; Department of Radiological Sciences, Neurointerventional Radiology Division, University of California, Irvine, CA, USA
| | - Bahadır Kırılmaz
- Department of Cardiology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Hasan Güngör
- Department of Cardiology, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
| | - İsa Durmaz
- Department of Cardiovascular Surgery, Tınaztepe Hospital, Izmir, Turkey
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Ghaffari S, Tajlil A, Aslanabadi N, Separham A, Sohrabi B, Saeidi G, Pourafkari L. Clinical and laboratory predictors of coronary slow flow in coronary angiography. Perfusion 2016; 32:13-19. [DOI: 10.1177/0267659116659918] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: The coronary slow-flow phenomenon (CSFP) is a multifactorial angiographic finding with no established pathogenesis. Objective: To investigate the role of clinical profile and laboratory findings in patients with CSFP. Methods: We prospectively recruited 69 patients with angiographically diagnosed CSFP and compared them with 88 patients with normal coronary flow. Demographic information, comorbidities and laboratory analysis, including complete blood count with differential, lipid profile and serum biochemical analysis, were documented and compared in univariate and multivariate analyses. Results: Patients with CSFP were more likely to be male and active smokers. Total cholesterol, triglyceride, hemoglobin and hematocrit, platelet count, mean platelet volume, platelet distribution width and red cell distribution width (RDW) were all higher in patients with CSFP. In multivariate regression analysis, including smoking, total cholesterol, hematocrit, fasting blood glucose and red cell distribution width, except fasting blood glucose, all variables were independently associated with CSFP. Receiver operating characteristic curve analysis revealed a cut-off point of 13.05% for RDW with a sensitivity of 74.6% and a specificity of 77.3% (p<0.001, AUC = 0.802) A cut-off value of 11.35% for PDW had a 89.9% sensitivity and 98.9% specificity for the prediction of CSFP (p<0.001, AUC = 0.970) Conclusion: The changes of circulating blood cell components in patients with CSFP may be indicative of underlying inflammation and endothelial dysfunction that should be investigated in experimental studies.
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Affiliation(s)
- Samad Ghaffari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arezou Tajlil
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Naser Aslanabadi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Separham
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bahram Sohrabi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Gholamreza Saeidi
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leili Pourafkari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Anesthesiology, University at Buffalo, Buffalo, NY, USA
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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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Zencir C, Akpek M, Senol S, Selvi M, Onay S, Cetin M, Akgullu C, Elbi H, Gungor H. Association between hematologic parameters and in-hospital mortality in patients with infective endocarditis. Kaohsiung J Med Sci 2015; 31:632-8. [PMID: 26709225 DOI: 10.1016/j.kjms.2015.10.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 10/03/2015] [Accepted: 10/07/2015] [Indexed: 10/22/2022] Open
Abstract
Early and accurate risk prediction is an important clinical demand in patients with infective endocarditis (IE). The platelet-to-lymphocyte ratio (PLR) is an independent predictor of worse prognosis in various cardiovascular diseases. The aim of this study was to determine the value of PLR in the prediction of in-hospital mortality among IE patients. We retrospectively analyzed the clinical, laboratory, and echocardiographic data of 59 adult patients with definite IE and in 40 adult controls. In-hospital mortality occurred in 16 (27%) patients. Vegetation size, levels of high-sensitive C-reactive protein and procalcitonin, neutrophil-to-lymphocyte ratio, and PLR were significantly higher in the in-hospital-mortality-positive group than in the in-hospital-mortality-negative group (p = 0.004, p = 0.009, p = 0.030, p = 0.001, and p = 0.008, respectively). Lymphocyte count was, however, significantly lower in the in-hospital-mortality-positive group (p = 0.004). In the receiver-operating characteristic analysis, PLRs over 191.01 predicted in-hospital mortality with 56.3% sensitivity and 81.4% specificity [area under the curve 0.725, 95% confidence interval (CI) 0.594-0.833; p = 0.0027]. In the multivariate analysis, PLR was found to be an independent predictor of in-hospital mortality in patients with IE (odds ratio 1.022, 95% CI 1.003-1.042; p = 0.021). In conclusion, higher PLR may predict in-hospital mortality in patients with IE.
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Affiliation(s)
- Cemil Zencir
- Department of Cardiology, Adnan Menderes University School of Medicine, Aydin, Turkey.
| | - Mahmut Akpek
- Department of Cardiology, Adnan Menderes University School of Medicine, Aydin, Turkey
| | - Sebnem Senol
- Department of Infectious Diseases and Clinical Microbiology, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Mithat Selvi
- Department of Cardiology, Adnan Menderes University School of Medicine, Aydin, Turkey
| | - Sevil Onay
- Department of Cardiology, Adnan Menderes University School of Medicine, Aydin, Turkey
| | - Mustafa Cetin
- Department of Cardiology, Adiyaman University School of Medicine, Adiyaman, Turkey
| | - Cagdas Akgullu
- Department of Cardiology, Adnan Menderes University School of Medicine, Aydin, Turkey
| | - Huseyin Elbi
- Department of Family Medicine, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Hasan Gungor
- Department of Cardiology, Adnan Menderes University School of Medicine, Aydin, Turkey
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Akdag S, Akyol A, Asker M, Duz R, Gumrukcuoglu HA. Platelet-to-Lymphocyte Ratio May Predict the Severity of Calcific Aortic Stenosis. Med Sci Monit 2015; 21:3395-400. [PMID: 26544152 PMCID: PMC4638279 DOI: 10.12659/msm.894774] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 07/20/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Platelet-to-lymphocyte ratio (PLR) is an emerging inflammatory indicator which is closely associated with adverse cardiovascular events. Therefore, we aimed to investigate the relationship between PLR and the severity of calcific aortic stenosis (AS). MATERIAL AND METHODS The study was designed as a retrospective study. A total of 86 consecutive patients with calcific AS were divided into two groups as mild-to-moderate AS and severe AS according to the transaortic mean pressure gradient. PLR levels were calculated from the complete blood count (CBC). RESULTS Platelet to lymphocyte ratio was significantly higher in severe and mild-to-moderate AS groups when compared to the control subjects (151±31.2, p<0.001, 138±28.8 vs. 126±26.5, p=0.008, respectively). In the subgroup analysis of AS patients, PLR was found to be higher in the severe AS group compared to mild-to-moderate group (p<0.001). A significant correlation was found between PLR and transaortic mean pressure gradient in patients with AS (r=0.421, p<0.001). CONCLUSIONS Our study results demonstrated that increased PLR correlates with the severity of calcific AS.
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Akboğa MK, Yayla Ç, Canpolat U, Aras D. Platelet to lymphocyte ratio: a novel and simple predictor of slow coronary flow. Anatol J Cardiol 2015; 15:679. [PMID: 26301354 PMCID: PMC5336877 DOI: 10.5152/anatoljcardiol.2015.6460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Mehmet Kadri Akboğa
- Clinic of Cardiology, Türkiye Yüksek İhtisas Training and Research Hospital; Ankara-Turkey.
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Akboga MK, Canpolat U, Yuksel M, Yayla C, Yilmaz S, Turak O, Ozeke O, Topaloglu S, Aras D. Platelet to lymphocyte ratio as a novel indicator of inflammation is correlated with the severity of metabolic syndrome: A single center large-scale study. Platelets 2015. [PMID: 26196312 DOI: 10.3109/09537104.2015.1064518] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Metabolic syndrome (MetS) as a cluster of several cardio-metabolic components is rapidly growing public-health problem worldwide and significantly associated with poor cardiovascular outcomes. Increased visceral adiposity activates the important pathways connecting low-grade chronic inflammation, oxidative stress and blood coagulation. Recently, platelet to lymphocyte ratio (PLR) has been evidenced as a novel indirect inflammatory marker. Therefore, for the first time, we aimed to investigate the association of PLR with both the presence and severity of MetS. In this cross-sectional study, a total of 1146 participants were enrolled (n = 539 with MetS and n = 607 without MetS). MetS was defined according to NCEP-ATP III criteria. MetS (+) group revealed significantly higher PLR and C-reactive protein (CRP) levels as compared to MetS (-) group (p < 0.05). There was a graded relationship between increasing number of MetS components and PLR (p < 0.05). Also, PLR was positively correlated with CRP level (r = 0.163, p < 0.001). In multivariate regression analysis, PLR [1.121 (1.113-1.135), p < 0.001], CRP [1.044 (1.029-1.060), p < 0.001], and age [1.030 (1.017-1.043), p < 0.001] were remained as independent predictors for the presence of MetS. In conclusion, our findings showed that increased PLR was significantly associated with both the presence and severity of MetS which was linked to systemic inflammation based on the correlation between PLR and CRP. As PLR is an easily available, simple and cheap indirect indicator of inflammation, it can be used in clinical practice as a predictor of MetS.
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Affiliation(s)
- Mehmet Kadri Akboga
- a Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic , Ankara , Turkey and
| | - Ugur Canpolat
- a Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic , Ankara , Turkey and
| | - Murat Yuksel
- b Dicle University Medical Faculty , Department of Cardiology , Diyarbakir , Turkey
| | - Cagri Yayla
- a Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic , Ankara , Turkey and
| | - Samet Yilmaz
- a Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic , Ankara , Turkey and
| | - Osman Turak
- a Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic , Ankara , Turkey and
| | - Ozcan Ozeke
- a Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic , Ankara , Turkey and
| | - Serkan Topaloglu
- a Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic , Ankara , Turkey and
| | - Dursun Aras
- a Turkiye Yuksek Ihtisas Training and Research Hospital, Cardiology Clinic , Ankara , Turkey and
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