Korean Circ J.  2016 Nov;46(6):821-826. 10.4070/kcj.2016.46.6.821.

The Association between Platelet/Lymphocyte Ratio and Coronary Artery Disease Severity in Asymptomatic Low Ejection Fraction Patients

• Uçar FM
• Açar B
• Gul M
• Ozeke O
• Aydogdu S

• KMID: 2355458
• DOI: http://doi.org/10.4070/kcj.2016.46.6.821

Abstract

BACKGROUND AND OBJECTIVES
Coronary angiography (CAG) is generally needed in the setting of systolic heart failure (HF) with an unidentified etiology as a part of diagnostic strategy. On the other hand, the clinical value of this invasive strategy is largely unknown. Platelet-lymphocyte ratio (PLR) has recently emerged as a novel inflammatory index that may serve as an important predictor of inflammatory state and overall mortality. The present study aimed to search the predictive value of PLR in determining the extent of coronary atherosclerosis in asymptomatic low ejection fraction (EF) patients.
SUBJECTS AND METHODS
156 asymptomatic heart failure (HF) subjects (without angina or HF symptoms, mean age: 58 years; to male: 71.2%) were enrolled, and thereafter a CAG was performed. Gensini Score was used to determine the severity of coronary artery disease (CAD) on CAG. According to this scoring system, the overall study group was categorized into three distinct subgroups: control group with the score 0, mild atherosclerosis group with the score 0 to 20 and severe atherosclerosis group with the score of >20. Thereafter, a comparison was made among groups with regard to mean values of PLR.
RESULTS
The severe atherosclerosis group had a substantially higher level of mean PLR in comparison to other groups (p<0.001). Pre-CAG PLR levels as well as a variety of clinical variables including age, low density lipoprotein (LDL)-cholesterol demonstrated an independent correlation with Gensini score through a multivariate analysis.
CONCLUSION
These findings suggest the potential association of high PLR levels with severe atherosclerosis in the setting of asymptomatic systolic HF. A simple measurement of PLR helps to identify the severity of coronary atherosclerosis prior to conducting coronary angiography.

Keyword

Low ejection fraction; Asymptomatic disease; Coronary artery disease; Gensini score; Platelet-lymphocyte ratio

MeSH Terms

Asymptomatic Diseases
Atherosclerosis
Coronary Angiography
Coronary Artery Disease*
Coronary Vessels*
Hand
Heart Failure
Heart Failure, Systolic
Humans
Lipoproteins
Male
Mortality
Multivariate Analysis
Lipoproteins

Figure

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  Fig. 1 Mean PLR of controls and mild and severe atherosclerosis groups. PLR: platelet-to-lymphocyte ratio.

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  Fig. 2 The ROC curve analysis of PLR for predicting severe atherosclerosis. ROC: receiver operating characteristic, CI: confidence interval, PLR: platelet-to-lymphocyte ratio.

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