Title : The impact of platelet/lymphocyte ratio and white blood cell/lymphocyte ratio on the prognosis of patients with acute ST segment elevation myocardial infarction undergoing PCI during hospitalization
Abstract:
Objective: The platelet-to-lymphocyte ratio (PLR) and white blood cell to lymphocyte ratio (WLR) are potential markers of inflammation. This study aimed to investigate the relationship between PLR, WLR, and the risk of major adverse cardiovascular events (MACE) in patients with STEMI during hospitalization.
Methods: This retrospective study included 403 patients with STEMI who underwent percutaneous coronary intervention (PCI). Patients were divided into MACE group (n=71) and non-MACE group (n=332) according to whether MACE occurred during hospitalization. Baseline characteristics, laboratory indicators, coronary angiography results, and MACE events were collected. Spearman correlation analysis was used to evaluate the correlation between PLR, WLR, and the risk of MACE and other clinical indicators. Univariate and multivariate logistic regression analysis was used to identify independent predictors of MACE.
Results:
- There were no significant differences in baseline characteristics between the two groups (P>0.05). The PLR (134.39±6.18) and WLR (9.56±1.04) were significantly higher in the MACE group than in the non-MACE group (123.68±6.25; 8.22±0.90, P<0.001). In addition, the SYNTAX score (22.17±1.52), TIMI flow grade 0?63.5%?were also significantly worse in the MACE group than in the non-MACE group (20.08±1.30;43.4%; P<0.05).
- Patients were divided into high and low groups according to the median PLR and WLR. The SYNTAX score (21.62±1.08), TIMI flow grade 0 (54.7%) were significantly worse in the high PLR group than in the low PLR group (19.29±0.98; 39.1%; P<0.05). The SYNTAX score (21.71±1.01), TIMI flow grade 0 (58.2%) were significantly worse in the high WLR group than in the low WLR group (19.20±0.82; 35.6%; P<0.05).
- Spearman correlation analysis showed that PLR (rs=0.556), WLR (rs=0.456), SYNTAX score (rs=0.472), TIMI flow grade (rs=0.156) were positively correlated with the occurrence of MACE (P<0.05).
- Univariate logistic regression analysis showed that PLR, WLR, SYNTAX score and TIMI flow grade 0 were risk factors for MACE (P<0.05). Multivariate logistic regression analysis furtherly confirmed that PLR (OR=1.992, 95%CI: 1.483-2.675, P<0.001), WLR (OR=2.386, 95%CI: 1.329-3.258, P<0.001) were independent predictors of MACE.
Conclusion: Higher PLR and WLR are associated with more severe coronary artery lesions, and higher risk of MACE. PLR and WLR are independent predictors of MACE in patients with STEMI during hospitalization.
Keywords: Acute St-Segment Elevation Myocardial Infarction; Platelet-To-Lymphocyte Ratio; White Blood Cell-To-Lymphocyte Ratio; Major Adverse Cardiac Events; Prognosis.
