Relationship of Platelet Counts and Inflammatory Markers to 30-Day Mortality Risk in Patients with Acute Type A Aortic Dissection

Abstract

Markers of prothrombotic state and inflammation are associated with the prognosis of patients with acute type A aortic dissection (AAAD). However, it is unclear that the relationship between these biomarkers and their combined impact on risk stratification. The present study evaluated the prognostic value of platelet counts, lymphocyte to neutrophil ratio (LNR), and lymphocyte to monocyte ratio (LMR), alone and in combination. A retrospective analysis of clinical data of 744 AAAD patients was conducted to identify whether these biomarkers were related to the 30-day mortality risk. A Kaplan-Meier analysis and log-rank test were used to compare survival between groups. A Cox hazard regression multivariable analysis was performed for 30-day mortality. Individual biomarker (platelet count, LNR, or LMR) was unable to predict 30-day mortality. However, combinations of all three biomarkers provided additive predictive value over either marker alone, the receiver operating characteristic (ROC) model had a prediction probability of 0.739 when platelet counts, LNR, and LMR were included. Cox hazard regression multivariable analysis showed that combinations of all three biomarkers were the strongest predictor of 30-day mortality (p<0.021). Combined with these three easily measurable biomarkers at admission, they could help identify AAAD patients with a high risk of 30-day mortality.

Elevated preoperative neutrophil‐to‐lymphocyte ratio predicts early adverse outcomes in uncomplicated type B aortic dissection undergoing TEVAR

“…The studies above implied that combinations of inflammatory markers have a satisfied predictive capability for the in-hospital mortality. In contrast, in a large sample cohort study of 744 patients with TAAD, combinations of platelet, neutrophil and lymphocyte were unable to predict 30-day mortality [22]. Interestingly, when investigators combined all three biomarkers (platelet counts, lymphocyte-to-neutrophil ratio and lymphocyte monocyte ratio) in the predictive model, it provided the strongest predictive value of 30-day mortality.…”

Low postoperative blood platelet count may be a risk factor for mortality in patients with acute type A aortic dissection

“…[22] Several previous studies have explored the relationship between platelets and prognosis in patients underwent aortic dissection. Chen [23] found that in patients with acute type A aortic dissection, platelet count, lymphocyte to Neutrophil ratio and lymphocyte to monocyte ratio may predict postoperative death of patients. Although the multi-factor prediction model is not of statistical signi cance, he believed that combined use of the three in multifactor analysis was necessary.…”

Efficacy of CRP In Combination With D-Dimer In Predicting Adverse Postoperative Outcomes of Patients With Acute Stanford Type A Aortic Dissection

“…The coagulation system is activated by extensive in ammation and the reverse is also true via crosstalk 16 . Attention have been focused on the prognostic value of individual indicators such as MLR and NLR for ATAAD in previous studies 17,18 , which is unable to obtain an ideal prediction e cacy. New research demonstrates that ATAAD results from a combination of in ammation and thrombosis 19 .…”

“…Chen et al demonstrated that individual biomarker like neutrophil to lymphocyte ratio and monocyte to lymphocyte ratio was unable to predict in-hospital mortality in patients with type A AAD 18 . Liu Jun et al…”

“…In ammation and thrombosis are two main mechanisms that contribute to the pathogenesis of ATAAD 2 . Based on that, in ammatory and thrombotic biomarkers associated with adverse outcomes are emerging 3,4 . Whether these in ammatory and thrombotic biomarkers as risk-prediction tools for the short-term results remains controversial.…”