Predictive value of platelet-to-lymphocyte ratio in severe degenerative aortic valve stenosis

Abstract

Background:Aortic valve stenosis (AVS) is the most common cause of left ventricular outflow obstruction, and its prevalence among elderly patients causes a major public health burden. Recently, platelet-to-lymphocyte ratio (PLR) has been recognized as a novel prognostic biomarker that offers information about both aggregation and inflammation pathways. Since PLR indicates inflammation, we hypothesized that PLR may be associated with the severity of AVS due to chronic inflammation pathways that cause stiffness and calcification of the aortic valve.Materials and Methods:We retrospectively enrolled 117 patients with severe degenerative AVS, who underwent aortic valve replacement and 117 control patients in our clinic. PLR was defined as the absolute platelet count divided by the absolute lymphocyte count. Severe AVS was defined as calcification and sclerosis of the valve with a mean pressure gradient of >40 mmHg.Results:PLR was 197.03 ± 49.61 in the AVS group and 144.9 ± 40.35 in the control group, which indicated a statistically significant difference (P < 0.001). A receiver operating characteristic (ROC) curve analysis demonstrated that PLR values over 188 predicted the severity of aortic stenosis with a sensitivity of 87% and a specificity of 70% (95% confidence interval = 0.734–0.882; P < 0.001; area under ROC curve: 0.808).Conclusion:We suggest that the level of PLR elevation is related to the severity of degenerative AVS, and PLR should be used to monitor patients' inflammatory responses and the efficacy of treatment, which will lead us to more closely monitor this high-risk population to detect severe degenerative AVS at an early stage.

The relationship between calcific severe aortic stenosis and systemic immune‐inflammation index

“…They were shown to possess predictive and/or prognostic roles in various CVD situations 10–12 . Evidence coming from previous studies demonstrated their predictive capacity also in severe AS 6–9 . In addition, increased NLR levels were found to be linked with short‐ and long‐term mortality in patients with AS undergoing aortic valve replacement surgery 21 .…”

“…TA B L E 2 Echocardiographic measurements of the study population demonstrated their predictive capacity also in severe AS. [6][7][8][9] In addition, increased NLR levels were found to be linked with shortand long-term mortality in patients with AS undergoing aortic valve replacement surgery. 21 Similarly, Condado et al showed that elevated NLR and PLR levels are associated with the occurrence of 30-day adverse outcomes in patients treated with transcatheter aortic valve replacement.…”

“…Accordingly, various biomarkers have been developed from the count of these cells in diverse combinations in order to predict the severity and prognosis of AS. Neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), and lymphocyte‐to‐monocyte ratio (LMR) are the most evident examples that were found to be related with the severity of AS in previous studies 6–9 . In addition, these markers were proven to be related with various cardiovascular disease (CVD) conditions 10–12 .…”

“…Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) are the most evident examples that were found to be related with the severity of AS in previous studies. [6][7][8][9] In addition, these markers were proven to be related with various cardiovascular disease (CVD) conditions. [10][11][12] In recent years, systemic immuneinflammation index (SII) has been developed that includes the peripheral counts of neutrophils, lymphocytes, and platelets, and was shown to be associated with poor outcomes in various types of cancers.…”

Observational Cross-Sectional Study of Inflammatory Markers After Transient Ischemic Attacks, Acute Coronary Syndromes, and Vascular Stroke Events

“…While we utilized IL-6 and hsCRP to monitor inflammation in our patient population, recent literature has suggested that other markers such as platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio may also accurately reflect inflammatory levels and have prognostic value in other inflammatory conditions. 25,26 While our study was not powered to answer these questions in a CV disease population, more research in this area will certainly be needed to further elucidate the role that these biomarkers could potentially play in coronary artery disease prognostication and management in the future.…”