Platelet-to-Albumin Ratio: The Prognostic Utility in the Prediction of 2-Month Postoperative Heart Transplant Complications

Overview

Journal J Cardiovasc Dev Dis

Specialty Cardiology & Vascular Diseases

Date 2023 Jun 27

PMID 37367406

Authors

Dragos-Florin Baba

Horatiu Suciu

Laurentiu Huma

Calin Avram

Alina Danilesco

Diana Andreea Moldovan

Andrei Stefan Opincar

Anca Ileana Sin

Affiliations

Soon will be listed here.

Abstract

Background: The platelet-to-albumin ratio (PAR), leucocyte-to-albumin ratio (LAR), neutrophil percentage-to-albumin ratio (NPAR), and monocyte-to-albumin ratio (MAR) represent easily reproducible markers, which may predict the outcomes in various diseases. Early postoperative complications might appear after heart transplantation, such as infections, diabetes mellitus type 2 (DM2), acute graft rejection, and atrial fibrillation (AFib).

Objective: The aim of our study was to investigate the PAR, LAR, NPAR, and MAR values before and after heart transplantation, and the associations of the preoperative levels of these markers with the presence of postoperative complications in first two months after surgery.

Methods: Our retrospective research was directed from May 2014 to January 2021, with a total number of 38 patients being included. We used cut-off values for the ratios from previously published studies, as well as our own determination of these levels by using a receiver operating characteristic (ROC) curve.

Results: By ROC analysis, the optimal preoperative PAR cut-off value was 38.84 (AUC: 0.771, = 0.0039), with 83.3% sensitivity, and 75.0% specificity. Applying a Chi square (χ) test, PAR > 38.84 represented an independent risk factor for complications, regardless of cause, and postoperative infections.

Conclusions: Preoperative PAR > 38.84 was a risk factor of developing complications of any cause, and postoperative infections in the first two months after heart transplantation.

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References

Dhaliwal A, Thohan V . Cardiac allograft vasculopathy: the Achilles' heel of long-term survival after cardiac transplantation. Curr Atheroscler Rep. 2006; 8(2):119-30. DOI: 10.1007/s11883-006-0049-1. View

Mossanen J, Jansen T, Pracht J, Liepelt A, Buendgens L, Stoppe C . Elevated circulating CD14CD16 intermediate monocytes are independently associated with extracardiac complications after cardiac surgery. Sci Rep. 2020; 10(1):947. PMC: 6976615. DOI: 10.1038/s41598-020-57700-9. View

Rosales C . Neutrophil: A Cell with Many Roles in Inflammation or Several Cell Types?. Front Physiol. 2018; 9:113. PMC: 5826082. DOI: 10.3389/fphys.2018.00113. View

Rauchhaus M, Doehner W, Francis D, Davos C, Kemp M, Liebenthal C . Plasma cytokine parameters and mortality in patients with chronic heart failure. Circulation. 2000; 102(25):3060-7. DOI: 10.1161/01.cir.102.25.3060. View

Kato T, Cheema F, Yang J, Kawano Y, Takayama H, Naka Y . Preoperative serum albumin levels predict 1-year postoperative survival of patients undergoing heart transplantation. Circ Heart Fail. 2013; 6(4):785-91. PMC: 4074373. DOI: 10.1161/CIRCHEARTFAILURE.111.000358. View

Kain V, Halade G . Role of neutrophils in ischemic heart failure. Pharmacol Ther. 2019; 205:107424. PMC: 6981275. DOI: 10.1016/j.pharmthera.2019.107424. View

Gawaz M . Role of platelets in coronary thrombosis and reperfusion of ischemic myocardium. Cardiovasc Res. 2004; 61(3):498-511. DOI: 10.1016/j.cardiores.2003.11.036. View

Gaul D, Stein S, Matter C . Neutrophils in cardiovascular disease. Eur Heart J. 2018; 38(22):1702-1704. DOI: 10.1093/eurheartj/ehx244. View

Zhang Z, Guo Q, Tang J, Zhang J, Cheng M, Song F . Monocyte-to-albumin ratio as a novel predictor of long-term adverse outcomes in patients after percutaneous coronary intervention. Biosci Rep. 2021; 41(7). PMC: 8243340. DOI: 10.1042/BSR20210154. View

10.

Ko C, Fang K, Tsai M, Lee Y, Lai C, Hsu C . Prognostic Value of Neutrophil Percentage-to-Albumin Ratio in Patients with Oral Cavity Cancer. Cancers (Basel). 2022; 14(19). PMC: 9564168. DOI: 10.3390/cancers14194892. View

11.

Hognestad A, Michelsen A, Brosstad F, Damas J, Holm T, Simonsen S . Platelet activation in heart transplant recipients. Clin Transplant. 2004; 18(2):142-7. DOI: 10.1046/j.1399-0012.2003.00137.x. View

12.

Talari K, Goyal M . Retrospective studies - utility and caveats. J R Coll Physicians Edinb. 2021; 50(4):398-402. DOI: 10.4997/JRCPE.2020.409. View

13.

Feng D, Cortese G, Baumgartner R . A comparison of confidence/credible interval methods for the area under the ROC curve for continuous diagnostic tests with small sample size. Stat Methods Med Res. 2015; 26(6):2603-2621. DOI: 10.1177/0962280215602040. View

14.

Shi C, Pamer E . Monocyte recruitment during infection and inflammation. Nat Rev Immunol. 2011; 11(11):762-74. PMC: 3947780. DOI: 10.1038/nri3070. View

15.

Huang Z, Zheng Q, Yu Y, Zheng H, Wu Y, Wang Z . Prognostic significance of platelet-to-albumin ratio in patients with esophageal squamous cell carcinoma receiving definitive radiotherapy. Sci Rep. 2022; 12(1):3535. PMC: 8894409. DOI: 10.1038/s41598-022-07546-0. View

16.

Kirsch R, Frith L, Black E, Hoffenberg R . Regulation of albumin synthesis and catabolism by alteration of dietary protein. Nature. 1968; 217(5128):578-9. DOI: 10.1038/217578a0. View

17.

Costanzo M, Dipchand A, Starling R, Anderson A, Chan M, Desai S . The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients. J Heart Lung Transplant. 2010; 29(8):914-56. DOI: 10.1016/j.healun.2010.05.034. View

18.

Yang Y, Yuan J, Liu L, Qie S, Yang L, Yan Z . Platelet-to-albumin ratio: a risk factor associated with technique failure and mortality in peritoneal dialysis patients. Ren Fail. 2021; 43(1):1359-1367. PMC: 8491659. DOI: 10.1080/0886022X.2021.1977319. View

19.

Shirazi L, Bissett J, Romeo F, Mehta J . Role of Inflammation in Heart Failure. Curr Atheroscler Rep. 2017; 19(6):27. DOI: 10.1007/s11883-017-0660-3. View

20.

Garcia-Martinez R, Caraceni P, Bernardi M, Gines P, Arroyo V, Jalan R . Albumin: pathophysiologic basis of its role in the treatment of cirrhosis and its complications. Hepatology. 2013; 58(5):1836-46. DOI: 10.1002/hep.26338. View