Combination of Mean Platelet Volume and Neutrophil to Lymphocyte Ratio Predicts Long-Term Major Adverse Cardiovascular Events After Percutaneous Coronary Intervention

Abstract

We hypothesized that the combination of a high neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) would be a stronger predictor of future cardiovascular events after percutaneous coronary intervention (PCI). Both NLR and MPV were measured in 364 consecutive patients undergoing PCI. The primary end point was the incidence of major adverse cardiovascular events (MACEs), including cardiac death, nonfatal myocardial infarction, and stent thrombosis. The median values of NLR and MPV were 2.8 and 8.2 fL, respectively. There were 26 MACEs during a median follow-up duration of 29.3 months. Kaplan-Meier analysis revealed that the higher NLR group had a significantly higher MACE rate than the lower NLR group and that the higher MPV group had a significantly higher MACE rate than the lower MPV group (log-rank: P = .0064 and P = .0004, respectively). The cumulative MACE-free survival can be further stratified by the combination of NLR and MPV. This value was especially useful in patients with acute coronary syndrome (ACS). By multivariate Cox proportional hazards model, the combination of high NLR and high MPV was independently associated with MACE ( P = .026). The combination of a high NLR and high MPV is an independent predictor of MACE after PCI, especially in patients with ACS.

Predictive efficacy of neutrophil-to-lymphocyte ratio for long-term prognosis in new onset acute coronary syndrome: a retrospective cohort study

“…The current understanding of the pathogenesis of atherosclerosis is focused on the "inflammatory hypothesis of atherothrombosis" theory [1,2]. Inflammatory cells and inflammatory signaling pathways play complex roles in the process of atherosclerosis, including initiating repair after vascular injury and mediating plaque instability and rupture, finally leading to acute coronary events [3][4][5][6].…”

The White Blood Cell Count to Mean Platelet Volume Ratio for the Prediction of Chronic Limb-Threatening Ischemia in Lower Extremity Artery Disease

“…Moreover, an analysis by Rief et al [17] lately pointed out a relation between decreasing mean platelet volume (MPV) and CLTI. Apart from that, several previous studies have already targeted platelet parameters and white blood cell count parameters, as well as combinations of them, in order to investigate their role as prognostic markers in patients with coronary artery disease (CAD) [18,19,20,21,22] and cerebrovascular disease [23,24,25,26].…”

Mean Platelet Volume, Neutrophil–Lymphocyte Ratio, and Long-Term Major Cardiovascular Events

“…10 The NLR is also influenced by dehydration, overhydration, diluted blood specimens, and in vitro blood specimen handling. 8 In conclusion, based on the work of Choi et al, 4 future work should evaluate the use of both MPV and NLR in clinical practice. Together, the NLR þ MPV may well turn out to be more useful predictors of vascular risk than either marker separately.…”

“…Considerable research in the last few years revealed that the mean platelet volume (MPV) and neutrophil-lymphocyte ratio (NLR) may play a role in the development, progression, and complication of several human disorders like metabolic syndrome (MS), atrial fibrillation, coronary artery disease. [1][2][3] In this issue of the journal, Choi et al 4 showed that in a multivariate Cox proportional hazards model, the combination of high NLR þ high MPV was independently (P ¼ .026) associated with major adverse cardiovascular events (including cardiac death, nonfatal myocardial infarction, and stent thrombosis).…”

“…The MPV increases up to 30% within 5 minutes of exposure with EDTA and increases further by 10% to 15% over 2 hours. 6 Choi et al 4 measured absolute neutrophil and lymphocyte counts and MPV within 2 hours after sample collections. Another limitation of using EDTA collection tubes is EDTA-dependent pseudothrombocytopenia; this may occur in a very low percentage of the general population.…”