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Prognostic Value of Platelet to Lymphocyte Ratio for Myocardial Infarction: A Systematic Review and Meta-Analysis
Hengxu Yu1, Shitao Li2, Yutong Wu1
1School of Medicine, Jiaxing University, Jiaxing, Zhejiang, China.
Insights
Elevated platelet-to-lymphocyte ratio (PLR) is significantly associated with increased mortality and major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI). This finding highlights PLR as a valuable prognostic biomarker for AMI patients.
Area of Science:
- Cardiology
- Hematology
- Clinical Biomarkers
Background:
- The prognostic significance of the platelet-to-lymphocyte ratio (PLR) in acute myocardial infarction (AMI) is increasingly recognized.
- However, comprehensive evidence-based data correlating PLR with clinical outcomes in AMI patients remains limited.
Purpose of the Study:
- To conduct a meta-analysis evaluating the association between PLR and prognosis in patients diagnosed with AMI.
- To assess the impact of elevated PLR on mortality and major adverse cardiovascular events (MACE) in this patient population.
Main Methods:
- A systematic literature search was performed across major databases (PubMed, Embase, Web of Science, Cochrane Library) up to April 19, 2024.
- Included were 18 cohort studies encompassing 16,545 AMI patients.
- Meta-analysis and subgroup analyses were conducted using Review Manager 5.4 & STATA 15.0 to assess mortality and MACE risks.
Main Results:
- Elevated PLR was significantly correlated with increased mortality in AMI patients (OR=1.06; 95% CI: 1.04-1.08).
- A strong association was found between higher PLR and MACE risk (OR=1.495; 95% CI: 1.24-1.80).
- Subgroup analyses confirmed these correlations across various patient demographics, study designs, and diagnostic criteria.
Conclusions:
- The platelet-to-lymphocyte ratio (PLR) is a significant prognostic biomarker for patients with acute myocardial infarction (AMI).
- Elevated PLR levels are demonstrably linked to higher mortality and MACE rates in AMI.
- PLR offers valuable insights for guiding therapeutic decisions and improving patient management in AMI care.
Background:
Correlations between platelet-to-lymphocyte ratio (PLR) and prognosis in patients with acute myocardial infarction (AMI) are reported in more studies, though there is no evidence-based data.
Methods:
Databases (PubMed, Embase, Web of Science, and Cochrane Library) were searched from their inception to April 19, 2024, to retrieve articles discussing associations between PLR and clinical outcomes in AMI patients. The primary outcomes, comprising mortality and major adverse cardiovascular events (MACE), were assessed with odds ratios (OR) and their 95% confidence intervals (CI). Sensitivity analyses and subgroup analyses were utilized to probe the results' robustness and potential heterogeneity sources. Analysis was carried out utilizing the software of Review Manager 5.4 & STATA 15.0.
Results:
This article selected 18 cohort studies, covering 16,545 AMI patients. The meta-analysis found that elevated PLR was significantly linked with mortality in AMI patients (OR = 1.06; 95% CI: 1.04-1.08, p < 0.00001). Additionally, PLR was highly linked with MACE risks in AMI patients (OR = 1.495; 95% CI: 1.24-1.80, p < 0.0001). Further subgroup analyses discovered a significant correlation between PLR and mortality in prospective studies (OR = 1.07; 95% CI: 1.05-1.09), studies with a sample size ≥ 500 (OR = 1.06; 95% CI: 1.04-1.08), patients under 70 years of age (OR = 1.07; 95% CI: 1.05-1.09), studies from European regions (OR = 1.08; 95% CI: 1.06-1.10), patients with ST-elevation myocardial infarction (OR = 1.09; 95% CI: 1.07-1.11), and those with a PLR cutoff value < 140 (OR = 1.07; 95% CI: 1.05-1.09) (p < 0.05). For MACE, similar subgroup analyses also proved an obvious correlation between PLR and MACE in the aforementioned subgroups (p < 0.05).
Conclusion:
PLR values are linked with mortality and MACE in AMI patients. PLR serves as an effective prognostic biomarker for AMI patients, providing precious opinions for sensible therapeutic decisions in AMI treatments.
