Platelet to lymphocyte ratio predicts all-cause mortality in patients with carotid arterial disease

Abstract

Background. Platelet to lymphocyte ratio (PLR) has been demonstrated as a risk and prognostic marker in many of cardiovascular diseases. A relationship between PLR and severity of carotid stenosis has been shown. The aim of our study was to investigate the relationship between PLR and all cause mortality in patients with carotid arterial disease.Methods. This retrospective study included 146 patients who had been performed selective carotid angiography. Carotid stenosis were graded by the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria. Platelet to lymphocyte ratio was calculated as the ratio of platelets to lymphocytes. The end point of the study was all-cause mortality.Results. During median follow-up of 16 months (0-65 months) 15 (10.3%) patients suffered all-cause mortality. 50 patients (34.2%) underwent carotid endarterectomy and 69 patients (47.3%) had non-carotid cardiac surgery. 38 patients (26.02%) had cerebrovascular events (stroke/transient ischemic attack) at admission. NASCET grades were not different between survivors and nonsurvivors. Non-survivors had significantly lower hemoglobin (Hb) levels (12.7 ± 1.6 g/dL vs. 13.7 ± 1.7 g/dL, p = 0.031) and they were older than survivors (74.2 ± 8.4 years vs. 68.6 ± 8.5 years, p = 0.029). Non-survivors had significantly higher PLR values compared with survivors (190.3 ± 85.6 and 126.8 ± 53.8, p = 0.017). In multivariate analysis, only PLR predicted all-cause mortality in patients with carotid artery stenosis.Conclusion. In our study, higher PLR was associated with increased all-cause mortality.

Association between platelet lymphocyte ratio and neutrophil lymphocyte ratio and clinical outcomes following carotid endarterectomy

“…2,10,11 PLR and NLR are markers that combine information on hemostasis and inflammation, with high sensitivity for demonstrating the inflammatory process. 3,7,[12][13][14][15][16] Several studies suggest that NLR and PLR can be markers of inflammatory activity in various diseases. 12,[14][15][16][17][18] Perioperative NLR and PLR levels are significantly correlated with patient morbidity and mortality rates in those undergoing percutaneous surgery, cardiac surgery, and vascular surgery procedures.…”

“…A total of 410 patients who underwent carotid endarterectomy surgery between 2002 and 2019 were initially selected. The institutional protocol required follow-up at the vascular surgery carotid outpatient clinic, where patients underwent control ultrasound at regular intervals postoperatively (1,3,6,9,12,18, and 24 months), performed by the same medical team. Restenosis was defined as presence of >70% stenosis identified in a postoperative imaging exam starting 1 month after surgery.…”

“…Approximately 30% of cases result from carotid stenosis. [1][2][3][4][5] Similar to coronary heart disease, inflammatory activity plays a significant role in the development and progression of atherosclerotic carotid disease. 3 Blood counts can provide valuable information in patients with carotid disease.…”

“…[1][2][3][4][5] Similar to coronary heart disease, inflammatory activity plays a significant role in the development and progression of atherosclerotic carotid disease. 3 Blood counts can provide valuable information in patients with carotid disease. White cell counts and their subtypes serve as systemic markers of inflammatory activity.…”

“…6 Previous studies have demonstrated that elevated levels of neutrophils and platelets together, along with reduced levels of lymphocytes, are associated with vascular diseases. 2,3,7,8 The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) have been proposed as markers that combine information on the atherosclerotic processes (hemostasis and inflammation) that can lead to plaque rupture. 7,8 Although several risk factors for complications after carotid endarterectomy have been identified in the literature, the existence of a biomarker that can estimate postoperative risk in these patients has not yet been proven.…”