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Impact of Platelet-to-Lymphocyte Ratio on Clinical Outcomes in Patients With ST-Segment Elevation Myocardial
Xi-Peng Sun1, Jing Li1, Wei-Wei Zhu1
11 Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Insights
A higher platelet-to-lymphocyte ratio (PLR) indicates increased risk of death, recurrent heart attack, heart failure, and stroke in ST-segment elevation myocardial infarction (STEMI) patients. Lower PLR is linked to better outcomes.
Area of Science:
- Cardiology
- Hematology
- Biomarkers
Background:
- ST-segment elevation myocardial infarction (STEMI) is a critical cardiovascular event.
- Inflammation plays a key role in STEMI pathophysiology and outcomes.
- The platelet-to-lymphocyte ratio (PLR) is an emerging inflammatory marker.
Purpose of the Study:
- To investigate the association between the platelet-to-lymphocyte ratio (PLR) and major clinical outcomes in STEMI patients.
- To determine if PLR can predict mortality, recurrent myocardial infarction, heart failure, arrhythmias, and ischemic stroke post-STEMI.
Main Methods:
- Retrospective analysis of 5886 STEMI patients categorized into four PLR quartiles.
- Cox proportional hazards models were used to assess the relationship between PLR and clinical outcomes.
- Follow-up duration averaged 81.6 months.
Main Results:
- The lowest mortality was observed in the lowest PLR quartile group.
- Higher PLR levels were significantly associated with increased all-cause mortality (P=0.006).
- Elevated PLR correlated with higher risks of recurrent myocardial infarction (Ptrend=.023), heart failure (Ptrend=.018), and ischemic stroke (Ptrend=.043).
Conclusions:
- A higher platelet-to-lymphocyte ratio is a significant predictor of adverse clinical outcomes in STEMI patients.
- PLR may serve as a valuable prognostic biomarker for risk stratification in STEMI.
- Further research is warranted to explore the clinical utility of PLR in STEMI management.
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.
