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Published on: January 28, 2020
The correlation between PLR-NLR and prognosis in acute myocardial infarction
Jia Liu1, Wei Ao1, Jianwei Zhou2
1Department of Cardiology, Yueyang Second People's Hospital Yueyang, China.
Insights
The combined platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) effectively predict prognosis in acute myocardial infarction (AMI). Higher PLR-NLR scores correlate with increased major adverse cardiovascular events (MACCE) and poorer survival outcomes.
Area of Science:
- Cardiology
- Inflammatory Biomarkers
- Prognostic Medicine
Background:
- Acute myocardial infarction (AMI) poses significant mortality risks.
- Predictive biomarkers are crucial for assessing AMI patient prognosis.
- Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are emerging inflammatory markers.
Purpose of the Study:
- To investigate the prognostic value of the combined PLR and NLR in patients with AMI.
- To determine the correlation between PLR-NLR levels and major adverse cardiovascular and cerebrovascular events (MACCE).
- To evaluate the impact of PLR-NLR on overall survival (OS) and progression-free survival (PFS) in AMI patients.
Main Methods:
- Retrospective analysis of 300 AMI patients (August 2016 - August 2019).
- Comparison of general data, MACCE, GRACE scores, and survival times across different PLR-NLR groups.
- Statistical analysis including Area Under the Curve (AUC) for PLR and NLR.
Main Results:
- Both PLR (AUC=0.810) and NLR (AUC=0.882) demonstrated significant prognostic value.
- The combined PLR-NLR scoring system showed distinct patient groups with varying clinical outcomes.
- Lower PLR-NLR scores were associated with lower heart rate, BNP, and cTnI levels, and reduced MACCE incidence.
- Group 0 (lowest PLR-NLR) exhibited superior OS and PFS, with a 100% 2-year survival rate.
Conclusions:
- The combination of PLR and NLR is a powerful tool for prognostic assessment in AMI.
- Increasing PLR-NLR scores are directly associated with a higher incidence of MACCE.
- The PLR-NLR index offers valuable insights into predicting long-term survival in AMI patients.
Objective:
To explore the correlation between the prognosis of acute myocardial infarction (AMI) and the platelet to lymphocyte ratio (PLR)-neutrophil to lymphocyte ratio (NLR).
Methods:
A retrospective analysis was performed on the data of 300 patients with AMI admitted to our hospital between August 2016 and August 2019. The general data, data on the patients' major adverse cardiovascular and cerebrovascular events (MACCE), the global registry of acute coronary events (GRACE), and the different groups of patients' survival times were compared.
Results:
The area under the curve (AUC) of PLR was 0.810 [95% CI (0.751, 0.869), P < 0.001]. The AUC value of NLR was 0.882 [95% CI (0.839, 0.925), P < 0.001]. In our study, 102 patients were placed in the high PLR group, 198 patients were placed in the low PLR group, 126 patients were placed in the high NLR group, 174 patients were placed in the low NLR group, 174 patients were placed in PLR-NLR group 0, 24 patients were placed in PLR-NLR group 1, and 102 patients were placed in PLR-NLR group 2. The heart rates (HR) and brain natriuretic peptide (BNP) levels in Group 0 were the lowest among the three groups (P < 0.05), and the cTnI levels were observably lower than they were in Group 2 (P < 0.05). The patients' HR and BNP ratios in Group 1 were notably lower than the HR and BNP ratios in Group 2 (P < 0.05). The lowest incidence of MACCE was found in PLR-NLR Group 0. The number of intermediate-risk of patients in Group 0 was the lowest among the three groups. The order of the overall survival (OS) and the progression-free survival (PFS) of the three PLR-NLR Groups 0 were Group 0 > Group 1 > Group 2 (P < 0.001). The survival rate (SR) of the patients in PLR-NLR Group 0 was 100% within 2 years, which was significantly greater than the survival rates in Group 1 and Group 2 (P < 0.05). The SR of the patients in Group 0 was 98.8% within five years, which was also significantly higher than the survival rates in Groups 1 and 2 (P < 0.05).
Conclusion:
The PLR-NLR combination has an essential effect on the prognostic analysis of AMI. The incidence of MACCE increases with an increase in PLR-NLR.
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