Platelet-to-lymphocyte ratio and prognosis in STEMI: a meta-analysis

Link to article at PubMed

Eur J Clin Invest. 2020 Aug 18:e13386. doi: 10.1111/eci.13386. Online ahead of print.


BACKGROUND: Platelet-to-lymphocyte ratio (PLR) is a hematological index which reflects increased level of inflammation and thrombosis. We aimed to summarize the potential prognostic role of PLR for the in-hospital and long-term outcomes in ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (pPCI) in a meta-analysis.

MATERIALS AND METHODS: Relevant cohort studies were identified by search the PubMed, Cochrane's Library, and Embase databases. A random-effect model was applied to pool the results. In-hospital and long-term outcomes were compared between patients with higher and lower preprocedural PLR.

RESULTS: Eleven cohorts with 12,619 patients were included. Pooled results showed that higher preprocedural PLR was indepdently associated with increased risk of in-hospital major adverse cardiovascular events (MACE, risk ratio [RR]: 1.76, 95% confidence interval [CI]: 1.39 to 2.22, p < 0.001; I2 = 49%), cardiac mortality (RR: 1.91, 95% CI: 1.18 to 3.09, p = 0.009; I2 = 0), all-cause mortality (RR: 2.14, 95% CI: 1.52 to 3.01, p < 0.001, I2 = 24%), and no reflow after pPCI (RR: 2.22, 95% CI: 1.70 to 2.90, p < 0.001, I2 = 59%). Moreover, higher preprocedural PLR was associated with increased risk of MACE (RR: 1.60, 95% CI: 1.25 to 2.03, I2 = 57%, p < 0.001) and all-cause mortality (RR: 2.36, 95% CI: 1.53 to 3.66, I2 = 78%, p < 0.001) during long-term follow-up of up to 82 months after discharge.

CONCLUSIONS: Higher PLR predicts poor in-hospital and long-term prognosis in STEMI patients after pPCI.

PMID:32810283 | DOI:10.1111/eci.13386

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