Increased Platelet-to-Lymphocyte Ratios and Low Relative Lymphocyte Counts Predict Appropriate Shocks in Heart
Kevser Gülcihan Balci1, Mustafa Mücahit Balci1, Ugur Arslan2
1Turkiye Yuksek Ihtisas Research and Education Hospital, Ankara.
Insights
Lower lymphocyte counts (L%) predict appropriate implantable cardioverter defibrillator (ICD) shocks in heart failure (HF) patients. Higher platelet-to-lymphocyte ratios (PLR) are also linked to shocks in HF patients with lower ejection fraction.
Area of Science:
- Cardiology
- Hematology
- Biomarkers
Background:
- Platelet-to-lymphocyte ratio (PLR) and relative lymphocyte count (L%) are accessible complete blood count parameters.
- Heart failure (HF) patients often receive implantable cardioverter defibrillators (ICDs) for primary prevention.
Purpose of the Study:
- To investigate the association between appropriate defibrillator therapy and PLR.
- To determine if decreased lymphocyte count predicts appropriate ICD shocks in HF patients.
Main Methods:
- 147 HF patients undergoing ICD implantation were analyzed.
- Peripheral blood samples were analyzed for white blood cell differentials and platelet counts.
- Patients were evaluated for appropriate ICD therapy.
Main Results:
- Patients receiving appropriate shocks had lower baseline ejection fraction.
- Higher median PLR and lower median L% were observed in the appropriate shock group.
- Decreased L% independently predicted appropriate shock therapy in multivariable analysis.
Conclusions:
- Higher PLRs are associated with appropriate shocks in ICD recipients with lower ejection fraction.
- Decreased L% is an independent predictor of appropriate shocks in heart failure patients.
Background:
Platelet-to-lymphocyte ratio (PLR) and relative lymphocyte count (L%) are commonly available tests that can be obtained from complete blood count. The aim of this study was to investigate the association between appropriate defibrillator therapy and PLR, and whether decreased lymphocyte count may predict appropriate implantable cardioverter defibrillator (ICD) shocks in heart failure (HF) patients.
Methods:
A total of 147 patients with ischemic or non-ischemic HF who underwent ICD implantation for primary prevention were enrolled in this study. Peripheral venous blood samples were drawn on the same day as ICD implantation. White blood cell counts with differentials, red blood cell indices, and platelet counts were calculated with an automated blood cell counter. All patients were evaluated according to the presence of appropriate ICD therapy.
Results:
Baseline ejection fraction was significantly lower in the appropriate shock received group (p = 0.040). Median PLR was significantly higher and L% was significantly lower in the appropriate shock received group (p < 0.001). In both ischemic and non-ischemic HF groups, median L% was significantly lower in the appropriate shock received group (p < 0.001; p = 0.006, respectively). In multivariable logistic regression analysis, only L% showed a strong association with appropriate shock therapy (p < 0.001).
Conclusions:
Higher PLRs are related to appropriate shocks in patients that received ICD with lower EF. Furthermore, decreased L% is independently associated with appropriate shocks in HF.
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