Platelet to Lymphocyte Ratio in the Prediction of Adverse Outcomes After Acute Coronary Syndrome: a Meta-analysis

Overview

Journal Sci Rep

Specialty Science

Date 2017 Jan 11

PMID 28071752

Citations 33

Authors

Wenzhang Li

Qianqian Liu

Yin Tang

Affiliations

Soon will be listed here.

Abstract

Recent studies have shown platelet to lymphocyte ratio (PLR) to be a potential inflammatory marker in cardiovascular diseases. We performed a meta-analysis to systematically evaluate the prognostic role of PLR in acute coronary syndrome (ACS). A comprehensive literature search up to May 18, 2016 was conducted from PUBMED, EMBASE and Web of science to identify related studies. The risk ratio (RR) with 95% confidence interval (CI) was extracted or calculated for effect estimates. Totally ten studies involving 8932 patients diagnosed with ACS were included in our research. We demonstrated that patients with higher PLR level had significantly higher risk of in-hospital adverse outcomes (RR = 2.24, 95%CI = 1.81-2.77) and long-term adverse outcomes (RR = 2.32, 95%CI = 1.64-3.28). Sensitivity analyses confirmed the stability of our results. We didn't detect significant publication bias by Begg's and Egger's test (p > 0.05). In conclusion, our meta-analysis revealed that PLR is promising biomarker in predicting worse prognosis in ACS patients. The results should be validated by future large-scale, standard investigations.

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References

Sen N, Yazici H, Tavil Y, Poyraz F, Turfan M, Aygul N . The relationship between admission hemoglobin level and left ventricular systolic functions in patients with first ST-segment elevated myocardial infarction. Turk Kardiyol Dern Ars. 2010; 38(4):233-8. View

Zhang J, Yu K . What's the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. JAMA. 1998; 280(19):1690-1. DOI: 10.1001/jama.280.19.1690. View

Schiariti M, Saladini P, Cuturello D, Iannetta L, Torromeo C, Puddu P . Decline in platelet count and long-term post-PCI ischemic events: implication of the intra-aortic balloon pump. Vascul Pharmacol. 2013; 60(1):25-31. DOI: 10.1016/j.vph.2013.11.002. View

Hudzik B, Szkodzinski J, Gorol J, Niedziela J, Lekston A, Gasior M . Platelet-to-lymphocyte ratio is a marker of poor prognosis in patients with diabetes mellitus and ST-elevation myocardial infarction. Biomark Med. 2015; 9(3):199-207. DOI: 10.2217/bmm.14.100. View

Hoaglin D . Misunderstandings about Q and 'Cochran's Q test' in meta-analysis. Stat Med. 2015; 35(4):485-95. DOI: 10.1002/sim.6632. View

Gu X, Sun S, Gao X, Xiong W, Qin S, Qi X . Prognostic value of platelet to lymphocyte ratio in non-small cell lung cancer: evidence from 3,430 patients. Sci Rep. 2016; 6:23893. PMC: 4812293. DOI: 10.1038/srep23893. View

Gawaz M, Langer H, May A . Platelets in inflammation and atherogenesis. J Clin Invest. 2005; 115(12):3378-84. PMC: 1297269. DOI: 10.1172/JCI27196. View

Kurtul A, Murat S, Yarlioglues M, Duran M, Ergun G, Acikgoz S . Association of platelet-to-lymphocyte ratio with severity and complexity of coronary artery disease in patients with acute coronary syndromes. Am J Cardiol. 2014; 114(7):972-8. DOI: 10.1016/j.amjcard.2014.07.005. View

Kurtul A, Yarlioglues M, Murat S, Ergun G, Duran M, Kasapkara H . Usefulness of the platelet-to-lymphocyte ratio in predicting angiographic reflow after primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction. Am J Cardiol. 2014; 114(3):342-7. DOI: 10.1016/j.amjcard.2014.04.045. View

10.

DerSimonian R, Laird N . Meta-analysis in clinical trials. Control Clin Trials. 1986; 7(3):177-88. DOI: 10.1016/0197-2456(86)90046-2. View

11.

Lindemann S, Kramer B, Seizer P, Gawaz M . Platelets, inflammation and atherosclerosis. J Thromb Haemost. 2007; 5 Suppl 1:203-11. DOI: 10.1111/j.1538-7836.2007.02517.x. View

12.

Puddu P, Lanti M, Menotti A, Mancini M, Zanchetti A, Cirillo M . Red blood cell count in short-term prediction of cardiovascular disease incidence in the Gubbio population study. Acta Cardiol. 2002; 57(3):177-85. DOI: 10.2143/AC.57.3.2005387. View

13.

Liberati A, Altman D, Tetzlaff J, Mulrow C, Gotzsche P, Ioannidis J . The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009; 339:b2700. PMC: 2714672. DOI: 10.1136/bmj.b2700. View

14.

Weng T, Fu T, Wang C, Hsu C, Wang J . Activation of lymphocyte autophagy/apoptosis reflects haemodynamic inefficiency and functional aerobic impairment in patients with heart failure. Clin Sci (Lond). 2014; 127(10):589-602. DOI: 10.1042/CS20130789. View

15.

Cetin E, Cetin M, Aras D, Topaloglu S, Temizhan A, Kisacik H . Platelet to Lymphocyte Ratio as a Prognostic Marker of In-Hospital and Long-Term Major Adverse Cardiovascular Events in ST-Segment Elevation Myocardial Infarction. Angiology. 2015; 67(4):336-45. DOI: 10.1177/0003319715591751. View

16.

Ayca B, Akin F, Celik O, Yuksel Y, Ozturk D, Tekiner F . Platelet to lymphocyte ratio as a prognostic marker in primary percutaneous coronary intervention. Platelets. 2014; 26(7):638-44. DOI: 10.3109/09537104.2014.968117. View

17.

Lloyd-Jones D, Camargo C, Allen L, Giugliano R, ODonnell C . Predictors of long-term mortality after hospitalization for primary unstable angina pectoris and non-ST-elevation myocardial infarction. Am J Cardiol. 2003; 92(10):1155-9. DOI: 10.1016/j.amjcard.2003.07.022. View

18.

Zouridakis E, Garcia-Moll X, Kaski J . Usefulness of the blood lymphocyte count in predicting recurrent instability and death in patients with unstable angina pectoris. Am J Cardiol. 2000; 86(4):449-51. DOI: 10.1016/s0002-9149(00)00963-2. View

19.

Roy D, Quiles J, Avanzas P, Arroyo-Espliguero R, Sinha M, Kaski J . A comparative study of markers of inflammation for the assessment of cardiovascular risk in patients presenting to the emergency department with acute chest pain suggestive of acute coronary syndrome. Int J Cardiol. 2005; 109(3):317-21. DOI: 10.1016/j.ijcard.2005.06.030. View

20.

Jennings L . Mechanisms of platelet activation: need for new strategies to protect against platelet-mediated atherothrombosis. Thromb Haemost. 2009; 102(2):248-57. DOI: 10.1160/TH09-03-0192. View