Platelet/ lymphocyte ratio for prediction of no reflow phenomenon in ST elevation myocardial infarction managed with primary percutanous coronary intervention

Badran, Hala Mahfouz; Fatah, Ahmed; Soltan, Ghada

doi:10.18053/jctres.06.202001.004

Cited by 4 publications

(4 citation statements)

References 39 publications

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“… 4 , 36 - 38 Indeed, several studies pertaining to cardiovascular reperfusion show a strong association of elevated PLR with the no-reflow phenomenon. 7 , 8 This may explain our observation that lower PLR levels collected at delayed timepoints were associated with good functional outcomes and higher delayed PLR levels with mortality in studies included in the systematic review, but admission PLR showed nonsignificant results in each of the treatment subgroups, as all included patients received RT and hence these phenomena may have occurred. These results should be interpreted with caution due to the publication bias detected in the delayed timepoints analysis.…”

Section: Discussionmentioning

confidence: 92%

“… 4 The platelet-lymphocyte ratio (PLR) is such a biomarker that has shown utility in emergency medicine and trauma settings, 5 acute illnesses such as acute coronary syndrome, 6 and cardiovascular reperfusion. 7 , 8 It is particularly promising as it could potentially provide insight into both inflammation and thrombotic/hemostatic mechanisms thought to play a role in AIS pathogenesis, whereas other biomarkers shown to have prognostic value such as C-Reactive Protein, platelet count and the neutrophil-lymphocyte ratio encompass only one of these mechanisms. 4 , 9 - 11 While there has been some evidence showing benefit of PLR in predicting clinical outcomes, 12 - 19 mortality 12 , 16 , 17 , 19 - 21 and bleeding risk 12 , 17 , 18 , 22 , 23 in AIS patients treated with reperfusion therapy (RT), this is yet to be clearly elucidated; to the best of our knowledge there is no systematic review or meta-analysis currently in the literature evaluating this.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Role of the Platelet-Lymphocyte Ratio in Acute Ischemic Stroke Patients Undergoing Reperfusion Therapy: A Meta-Analysis

Sharma

Bhaskar

2022

J Cent Nerv Syst Dis

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Background Both inflammation and thrombotic/hemostatic mechanisms may play a role in acute ischemic stroke (AIS) pathogenesis, and a biomarker, such as the platelet-to-lymphocyte ratio (PLR), considering both mechanisms may be of clinical utility. Objectives This meta-analysis sought to examine the effect of PLR on functional outcomes, early neurological changes, bleeding complications, mortality, and adverse outcomes in AIS patients treated with reperfusion therapy (RT). Design Systematic Review and Meta-Analysis Data Sources and Methods Individual studies were retrieved from the PubMed/Medline, EMBASE and Cochrane databases. References thereof were also consulted. Data were extracted using a standardised data sheet, and systematic reviews and meta-analyses on the association of admission (pre-RT) or delayed (post-RT) PLR with defined clinical and safety outcomes were conducted. In the case of multiple delayed PLR timepoints, the timepoint closest to 24 hours was selected. Results Eighteen studies (n=4878) were identified for the systematic review, of which 14 (n=4413) were included in the meta-analyses. PLR collected at admission was significantly negatively associated with 90-day good functional outcomes (SMD=−.32; 95% CI = −.58 to −.05; P=.020; z=−2.328), as was PLR collected at delayed timepoints (SMD=−.43; 95% CI = −.54 to −.32; P<.0001; z=−7.454). PLR at delayed timepoints was also significantly negatively associated with ENI (SMD=−.18; 95% CI = −.29 to −.08; P=.001. Conversely, the study suggested that a higher PLR at delayed timepoints may be associated with radiological bleeding and mortality. The results varied based on the type of RT administered. Conclusions A higher PLR is associated with worse outcomes after stroke in terms of morbidity, mortality, and safety outcomes after stroke.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Prognostic Role of the Platelet-Lymphocyte Ratio in Acute Ischemic Stroke Patients Undergoing Reperfusion Therapy: A Meta-Analysis

Sharma

Bhaskar

2022

J Cent Nerv Syst Dis

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“…PLR was considerably greater in the no-reflow group compared to the group with normal reflow in a total of 200 patients with STEMI who had pPCI. No-reflow was detected in 29% of these patients [ 41 ]. Similar to this, Enöz O. et al claim that PLR is a widely accessible inflammatory biomarker that may be used to predict the no-reflow event after thrombus aspiration during PCI in patients with STEMI [ 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…High levels were independent predictors of the no-reflow phenomenon and intracoronary thrombus burden [ 41 , 42 , 43 ].…”

Section: Figurementioning

confidence: 99%

Assessment of Inflammatory Hematological Ratios (NLR, PLR, MLR, LMR and Monocyte/HDL–Cholesterol Ratio) in Acute Myocardial Infarction and Particularities in Young Patients

Tudurachi,

Anghel,

Tudurachi

et al. 2023

IJMS

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Cardiovascular disease, particularly coronary artery disease (CAD), remains a predominant cause of mortality globally. Factors such as atherosclerosis and inflammation play significant roles in the pathogenesis of CAD. The nexus between inflammation and CAD is underscored by the role of immune cells, such as neutrophils, lymphocytes, monocytes, and macrophages. These cells orchestrate the inflammatory process, a core component in the initiation and progression of atherosclerosis. The activation of these pathways and the subsequent lipid, fibrous element, and calcification accumulation can result in vessel narrowing. Hematological parameters derived from routine blood tests offer insights into the underlying inflammatory state. Recent studies have highlighted the potential of inflammatory hematological ratios, such as the neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio and lymphocyte/monocyte ratio. These parameters are not only accessible and cost-effective but also mirror the degree of systemic inflammation. Several studies have indicated a correlation between these markers and the severity, prognosis, and presence of CAD. Despite the burgeoning interest in the relationship between inflammatory markers and CAD, there remains a paucity of data exploring these parameters in young patients with acute myocardial infarction. Such data could offer valuable insights into the unique pathophysiology of early-onset CAD and improve risk assessment and predictive strategies.

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The predictive value of the HALP score for no-reflow phenomenon and short-term mortality in patients with ST-elevation myocardial infarction

Toprak,

Acar

et al. 2024

Postgraduate Medicine

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Platelet/ lymphocyte ratio for prediction of no reflow phenomenon in ST elevation myocardial infarction managed with primary percutanous coronary intervention

Cited by 4 publications

References 39 publications

Prognostic Role of the Platelet-Lymphocyte Ratio in Acute Ischemic Stroke Patients Undergoing Reperfusion Therapy: A Meta-Analysis

Prognostic Role of the Platelet-Lymphocyte Ratio in Acute Ischemic Stroke Patients Undergoing Reperfusion Therapy: A Meta-Analysis

Assessment of Inflammatory Hematological Ratios (NLR, PLR, MLR, LMR and Monocyte/HDL–Cholesterol Ratio) in Acute Myocardial Infarction and Particularities in Young Patients

The predictive value of the HALP score for no-reflow phenomenon and short-term mortality in patients with ST-elevation myocardial infarction

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