Impact of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio on 5-Year Clinical Outcomes of Patients with Stable Coronary Artery Disease Undergoing Elective Percutaneous Coronary Intervention

Overview

Journal J Cardiovasc Transl Res

Publisher Springer

Specialty Cardiology & Vascular Diseases

Date 2018 Oct 3

PMID 30276618

Citations 23

Authors

Edoardo Bressi

Fabio Mangiacapra

Elisabetta Ricottini

Ilaria Cavallari

Iginio Colaiori

Giuseppe Di Gioia

Antonio Creta

Marialessia Capuano

Michele Mattia Viscusi

Germano Di Sciascio

Affiliations

Soon will be listed here.

Abstract

The prognostic role of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with stable coronary artery disease (CAD) is still unclear. We enrolled 500 patients undergoing elective percutaneous coronary intervention (PCI). Blood samples were drawn prior to PCI for NLR and PLR calculation. Major adverse clinical events (MACE), which included death, myocardial infarction (MI), and target vessel revascularization (TVR), were recorded up to 5 years. Patients in the higher tertile of NLR presented higher Kaplan-Meier estimates of MACE (26.0% vs. 16.9% in tertile 2 vs. 14.3% in tertile 1; p = 0.042) and death (12.0% vs 6.9% in tertile 2 vs. 4.6% in tertile 1; p = 0.040), whereas there were no significant differences in the estimates of MI and TVR. NLR in the higher tertile was an independent predictor of MACE (HR 1.65, 95% CI 1.07-2.55, p = 0.024). No significant difference was observed across tertiles of PLR. Unlike PLR, elevated pre-procedural NLR is associated with an increased risk of 5-year clinical adverse events.

Citing Articles

Neutrophil to lymphocyte ratio and five-year mortality in patients with acute ischemic stroke.

Shan Y, Zhang R, Lu J, Huang L, Wang Y, Long F Heliyon. 2024; 10(17):e36827.

PMID: 39281440 PMC: 11395762. DOI: 10.1016/j.heliyon.2024.e36827.

Analysis of risk factors for PCI no-reflow in coronary heart disease and construction of related prediction models.

Zhang L, Lin J, Luo L, Liu B, Zeng X Am J Transl Res. 2024; 16(8):3733-3741.

PMID: 39262730 PMC: 11384415. DOI: 10.62347/ECNI6080.

Neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio associated with 28-day all-cause mortality in septic patients with coronary artery disease: a retrospective analysis of MIMIC-IV database.

Li X, Chen Y, Yuan Q, Zhou H, Lu L, Guo R BMC Infect Dis. 2024; 24(1):749.

PMID: 39075364 PMC: 11288105. DOI: 10.1186/s12879-024-09516-5.

Analysis of the correlation between the Systemic Inflammatory Response Index and the severity of coronary vasculopathy.

He T, Luo Y, Wan J, Hou L, Su K, Zhao J Biomol Biomed. 2024; 24(6):1726-1734.

PMID: 38907736 PMC: 11496849. DOI: 10.17305/bb.2024.10747.

Discordance Between Neutrophil to Lymphocyte Ratio and High Sensitivity C-Reactive Protein to Predict Clinical Events in Patients with Stable Coronary Artery Disease: A Large-Scale Cohort Study.

He J, Song C, Zhang R, Yuan S, Li J, Dou K J Inflamm Res. 2023; 16:5439-5450.

PMID: 38026249 PMC: 10674642. DOI: 10.2147/JIR.S428734.

References

Hicks K, Tcheng J, Bozkurt B, Chaitman B, Cutlip D, Farb A . 2014 ACC/AHA Key Data Elements and Definitions for Cardiovascular Endpoint Events in Clinical Trials: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop.... J Am Coll Cardiol. 2015; 66(4):403-69. DOI: 10.1016/j.jacc.2014.12.018. View

Van Tassell B, Toldo S, Mezzaroma E, Abbate A . Targeting interleukin-1 in heart disease. Circulation. 2013; 128(17):1910-23. PMC: 3938092. DOI: 10.1161/CIRCULATIONAHA.113.003199. View

Neuen B, Leather N, Greenwood A, Gunnarsson R, Cho Y, Mantha M . Neutrophil-lymphocyte ratio predicts cardiovascular and all-cause mortality in hemodialysis patients. Ren Fail. 2015; 38(1):70-6. DOI: 10.3109/0886022X.2015.1104990. View

Mangiacapra F, Colaiori I, Ricottini E, Creta A, Di Gioia G, Cavallari I . Impact of platelet reactivity on 5-year clinical outcomes following percutaneous coronary intervention: a landmark analysis. J Thromb Thrombolysis. 2018; 45(4):496-503. DOI: 10.1007/s11239-018-1630-5. View

Ricottini E, Mangiacapra F, Nusca A, Melfi R, Cavallari I, Miglionico M . Relation of Platelet Indexes to Platelet Reactivity and Periprocedural Myocardial Infarction in Patients Who Underwent Percutaneous Coronary Angioplasty. Am J Cardiol. 2018; 121(9):1027-1031. DOI: 10.1016/j.amjcard.2018.01.013. View

Park J, Jang H, Oh I, Yoon C, Suh J, Cho Y . Prognostic value of neutrophil to lymphocyte ratio in patients presenting with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Am J Cardiol. 2013; 111(5):636-42. DOI: 10.1016/j.amjcard.2012.11.012. View

White H, Thygesen K, Alpert J, Jaffe A . Universal MI definition update for cardiovascular disease. Curr Cardiol Rep. 2014; 16(6):492. DOI: 10.1007/s11886-014-0492-5. View

Ridker P, Everett B, Thuren T, MacFadyen J, Chang W, Ballantyne C . Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease. N Engl J Med. 2017; 377(12):1119-1131. DOI: 10.1056/NEJMoa1707914. View

Mangiacapra F, Barbato E . Clinical implications of platelet-vessel interaction. J Cardiovasc Transl Res. 2012; 6(3):310-5. DOI: 10.1007/s12265-012-9441-0. View

10.

Bressi E, Mangiacapra F, Ricottini E, Cavallari I, Colaiori I, Di Gioia G . Relation of Neutrophil to Lymphocyte Ratio With Periprocedural Myocardial Damage in Patients Undergoing Elective Percutaneous Coronary Intervention. Am J Cardiol. 2016; 118(7):980-4. DOI: 10.1016/j.amjcard.2016.07.015. View

11.

Muller O, Hamilos M, Bartunek J, Ulrichts H, Mangiacapra F, Holz J . Relation of endothelial function to residual platelet reactivity after clopidogrel in patients with stable angina pectoris undergoing percutaneous coronary intervention. Am J Cardiol. 2010; 105(3):333-8. DOI: 10.1016/j.amjcard.2009.09.033. View

12.

Wang X, Zhang G, Jiang X, Zhu H, Lu Z, Xu L . Neutrophil to lymphocyte ratio in relation to risk of all-cause mortality and cardiovascular events among patients undergoing angiography or cardiac revascularization: a meta-analysis of observational studies. Atherosclerosis. 2014; 234(1):206-13. DOI: 10.1016/j.atherosclerosis.2014.03.003. View

13.

Seropian I, Romeo F, Pizarro R, Vulcano N, Posatini R, Marenchino R . Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as predictors of survival after heart transplantation. ESC Heart Fail. 2017; 5(1):149-156. PMC: 5793982. DOI: 10.1002/ehf2.12199. View

14.

Mangiacapra F, Bartunek J, Bijnens N, Peace A, Dierickx K, Bailleul E . Periprocedural variations of platelet reactivity during elective percutaneous coronary intervention. J Thromb Haemost. 2012; 10(12):2452-61. DOI: 10.1111/jth.12016. View

15.

Lee Y, Baradi A, Peverelle M, Sultani R, Adams H, Garlick J . Usefulness of Platelet-to-Lymphocyte Ratio to Predict Long-Term All-Cause Mortality in Patients at High Risk of Coronary Artery Disease Who Underwent Coronary Angiography. Am J Cardiol. 2018; 121(9):1021-1026. DOI: 10.1016/j.amjcard.2018.01.018. View

16.

Leader A, Pereg D, Lishner M . Are platelet volume indices of clinical use? A multidisciplinary review. Ann Med. 2012; 44(8):805-16. DOI: 10.3109/07853890.2011.653391. View

17.

Oledzki S, Kornacewicz-Jach Z, Safranow K, Kiedrowicz R, Gawronska-Szklarz B, Jastrzebska M . Variability of platelet response to clopidogrel is not related to adverse cardiovascular events in patients with stable coronary artery disease undergoing percutaneous coronary intervention. Eur J Clin Pharmacol. 2017; 73(9):1085-1094. DOI: 10.1007/s00228-017-2271-x. View

18.

Onsrud M, Thorsby E . Influence of in vivo hydrocortisone on some human blood lymphocyte subpopulations. I. Effect on natural killer cell activity. Scand J Immunol. 1981; 13(6):573-9. DOI: 10.1111/j.1365-3083.1981.tb00171.x. View

19.

Hotchkiss R, Karl I . The pathophysiology and treatment of sepsis. N Engl J Med. 2003; 348(2):138-50. DOI: 10.1056/NEJMra021333. View

20.

Cho K, Ann S, Singh G, Her A, Shin E . Combined Usefulness of the Platelet-to-Lymphocyte Ratio and the Neutrophil-to-Lymphocyte Ratio in Predicting the Long-Term Adverse Events in Patients Who Have Undergone Percutaneous Coronary Intervention with a Drug-Eluting Stent. PLoS One. 2015; 10(7):e0133934. PMC: 4514869. DOI: 10.1371/journal.pone.0133934. View