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Usefulness of Platelet-Lymphocyte Ratio to Predict Stent Thrombosis in Patients with ST Elevation Myocardial Infarction

Year 2014, Volume: 17 Issue: 2, 81 - 85, 01.02.2013
https://doi.org/10.4274/khj.88597

Abstract

Introduction: Stent thrombosis, an iatrogenic disease, is an important complication of percutaneous coronary intervention (PCI). The platelet to lymphocyte ratio (PLR) has been recently proposed to be a marker of thrombosis and inflammation, mainly in cancer patients. The aim of this study was to determine whether PLR in patients presenting with acute ST elevation myocardial infarction (STEMI) is predictive of the development of stent thrombosis.Patients and Methods: We retrospectively analyzed the clinical, hematologic, and angiographic data of total 201 patients (mean age 59.8±13.1 years, 3 out of 4 were males) who had undergone PCI for acute STEMI and a further control coronary angiography. 54 of them were diagnosed as stent thrombosis and formed the patient group and 147 patients matched with patient group in terms of age, gender, traditional coronary risk factors, stent implantation procedure, and stent type and length formed the control group in whom the stent implanted during primary PCI was found patent in the repeat coronary angiography.Results: The pre-procedural PLR was significantly higher in patients with stent thrombosis compared to patients without stent thrombosis (176±68 vs. 135±62; p

References

  • Steg PG, James SK, Atar D, Badano LP, Blömstrom-Lundqvist C, Borger MA, et al. Task Force on the management of ST-segment elevation acute myocardial infarction of the ESC, ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 2012;33:2569-619.
  • Dangas GD, Caixeta A, Mehran R, Parise H, Lansky AJ, Cristea E, et al. Frequency and predictors of stent thrombosis after percutaneous coronary intervention in acute myocardial infarction. Circulation 2011;123:1745-56.
  • Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med 2005;352:1685-95.
  • Kaya H, Ertas F, Islamoglu Y, Kaya Z, Atilgan ZA, Cil H, et al. Association Between Neutrophil to Lymphocyte Ratio and Severity of Coronary Artery Disease. Clin Appl Thromb Hemost 2013.
  • Sen N, Afsar B, Ozcan F, Buyukkaya E, Isleyen A, Akcay AB, et al. The neutrophil to lymphocyte ratio was associated with impaired myocardial perfusion and long term adverse outcome in patients with ST-elevated myocardial infarction undergoing primary coronary intervention. Atherosclerosis 2013;228:203-10.
  • Yıldız A, Kaya H, Ertaş F, Oylumlu M, Bilik MZ, Yüksel M, et al Association between neutrophil to lymphocyte ratio and pulmonary arterial hypertension. Türk Kardiyol Dern Arş 2013;41:604-9
  • Akpek M, Kaya MG, Lam YY, Sahin O, Elcik D, Celik T, et al. Relation of neutrophil/lymphocyte ratio to coronary flow to in-hospital major adverse cardiac events in patients with ST-elevated myocardial infarction undergoing primary coronary intervention. Am J Cardiol 2012;110:621-7.
  • Niccoli G, Lanza GA, Spaziani C, Altamura L, Romagnoli E, Leone AM, et al. Baseline systemic inflammatory status and no-reflow phenomenon after percutaneous coronary angioplasty for acute myocardial infarction. Int J Cardiol 2007;117:306-11.
  • Yildiz A, Akil MA, Kayan F, Yuksel M, Bilik MZ, Oylumlu M, et al. Assessment of neutrophil/lymphocyte ratio in patients with myocardial bridge. J Clin Exp Invest 2013.
  • Smith RA, Ghaneh P, Sutton R, Raraty M, Campbell F, Neoptolemos JP. Prognosis of resected ampullary adenocarcinoma by preoperative serum CA19- 9 levels and platelet-lymphocyte ratio. J Gastrointest Surg 2008;12:1422-8.
  • Wang D, Yang JX, Cao DY, Wan XR, Feng FZ, Huang HF, et al. Preoperative neutrophil-lymphocyte and platelet-lymphocyte ratios as independent predictors of cervical stromal involvement in surgically treated endometrioid adenocarcinoma. Onco Targets Ther 2013;6:211-6.
  • Azab B, Shah N, Akerman M, McGinn JT Jr. Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-ST-elevation myocardial infarction. J Thromb Thrombolysis 2012;34:326-34.
  • Acar G, Kalkan ME, Avci A, Alizade E, Tabakci MM, Toprak C, et al. The Relation of Platelet-Lymphocyte Ratio and Coronary Collateral Circulation in Patients With Stable Angina Pectoris and Chronic Total Occlusion. Clin Appl Thromb Hemost 2013.
  • Cutlip DE, Windecker S, Mehran R, Boam A, Cohen DJ, van Es GA, et al. Clinical end points in coronary stent trials: a case for standardized definitions. Circulation 2007;115:2344-51.
  • Leibundgut G, Nietlispach F, Pittl U, Brunner-La Rocca H, Kaiser CA, Pfisterer ME. Stent thrombosis up to 3 years after stenting for ST-segment elevation myocardial infarction versus for stable angina comparison of the effects of drug-eluting versus bare-metal stents. Am Heart J 2009;158:271-6.
  • Kukreja N, Onuma Y, Garcia-Garcia HM, Daemen J, van Domburg R, Serruys PW. The risk of stent thrombosis in patients with acute coronary syndromes treated with bare-metal and drug-eluting stents. J Am Coll Cardiol Intv 2009;2:534-41.
  • Nakazawa G, Finn AV, Joner M, Ladich E, Kutys R, Mont EK, et al. Delayed arterial healing and increased late stent thrombosis at culprit sites after drug- eluting stent placement for acute myocardial infarction patients: an autopsy study. Circulation 2008;118:1138-45.
  • Fujii K, Carlier SG, Mintz GS, Yang YM, Moussa I, Weisz G, et al. Stent underexpansion and residual reference segment stenosis are related to stent thrombosis after sirolimus-eluting stent implantation: an intravascular ultrasound study. J Am Coll Cardiol 2005;45:995-8.
  • Hassan AK, Bergheanu SC, Stijnen T, van der Hoeven BL, Snoep JD, Plevier JW, et al. Late stent malapposition risk is higher after drug-eluting stent compared with bare-metal stent implantation and associates with late stent thrombosis. Eur Heart J 2010;31:1172-80.
  • Nikolsky E, Grines CL, Cox DA, Garcia E, Tcheng JE, Sadeghi M, et al. Impact of baseline platelet count in patients undergoing primary percutaneous coronary intervention in acute myocardial infarction (from the CADILLAC trial). Am J Cardiol 2007;99:1055-61.
  • Zhang SZ, Jin YP, Qin GM, Wang JH . Association of platelet–monocyte aggregates with platelet activation, systemic inflammation, and myocardial injury in patients with non-st elevation acute coronary syndromes. Clin Cardiol 2007;30:26-31
  • Azab B, Torbey E, Singh J, Akerman M, Khoueiry G, McGinn JT, et al. Mean platelet volume/platelet count ratio as a predictor of long-term mortality after non-ST-elevation myocardial infarction. Platelets 2011;22:557-66.
  • Iijima R, Ndrepepa G, Mehilli J, Bruskina O, Schulz S, Schömig A, et al. Relationship between platelet count and 30 day clinical outcomes after percutaneous coronary interventions. Pooled analysis of four ISAR trials. Thromb Haemost 2007;98:852-7.
  • Lordkipanidze M, Diodati JG, Turgeon J, Schampaert E, Palisaitis DA, Pharand C. Platelet count, not oxidative stress, may contribute to inadequate platelet inhibition by aspirin. Int J Cardiol 2010;143:43-50.
  • Furman MI, Benoit SE, Barnard MR, Valeri CR, Borbone ML, Becker RC, et al. Increased platelet reactivity and circulating monocyte-platelet aggregates in patients with stable coronary artery disease. J Am Coll Cardiol 1998;31:352-8.
  • Zouridakis EG, Garcia-Moll X, Kaski JC. Usefulness of the blood lymphocyte count in predicting recurrent instability and death in patients with unstable angina pectoris. Am J Cardiol 2000;86:449-51
  • Ommen SR, Gibbons RJ, Hodge DO, Thomson SP. Usefulness of the lymphocyte concentration as a prognostic marker in coronary artery disease. Am J Cardiol 1997;79:812-4.
  • Ommen SR, Hodge DO, Rodeheffer RJ, McGregor CG, Thomson SP, Gibbons RJ. Predictive power of the relative lymphocyte concentration in patients with advanced heart failure. Circulation 1998;97:19-22.
  • Thomson SP, McMahon LJ, Nugent CA. Endogenous cortisol: a regulator of the number of lymphocytes in peripheral blood. Clin Immunol Immunopathol 1980;17:506-14
  • Raungkaewmanee S, Tangjitgamol S, Manusirivithaya S, Srijaipracharoen S, Thavaramara T. Platelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer. J Gynecol Oncol 2012;23:265-73.
  • Bhatti I, Peacock O, Lloyd G, Larvin M, Hall RI. Preoperative hematologic markers as independent predictors of prognosis in resected pancreatic ductal adenocarcinoma: neutrophil-lymphocyte versus platelet-lymphocyte ratio. Am J Surg 2010;200:197-203.
  • Sunbul M, Gerin F, Durmus E, Kivrak T, Sari I, Tigen K, et al. Neutrophil to lymphocyte and platelet to lymphocyte ratio in patients with dipper versus non-dipper hypertension. Clin Exp Hypertens 2014;36:217-21.

ST Yükselmeli Miyokard İnfarktüslü Hastalarda Stent Trombozunu Öngörmede Trombosit-Lenfosit Oranının Kullanışlılığı

Year 2014, Volume: 17 Issue: 2, 81 - 85, 01.02.2013
https://doi.org/10.4274/khj.88597

Abstract

Giriş: İyatrojenik bir hastalık olan stent trombozu, perkutan koroner girişimin (PCI) önemli bir komplikasyonudur. Trombosit lenfosit oranının (PLR) son zamanlarda daha çok kanser hastalarında, tromboz ve inflamasyonun bir belirteci olduğu gösterilmiştir. Bu çalışmanın amacı akut ST yükselmeli miyokard infarktüsü (STYMİ) ile başvuran hastalarda PLR'nin stent trombozu gelişiminin bir öngördürücüsü olup olmadığını araştırmaktır.Hastalar ve Yöntem: Akut ST yükselmeli miyokard infarktüsü tanısıyla primer PCI yapılan ve daha sonra stabil anjina veya Akut koroner sendrom tanısıyla tekrar koroner anjiyografi yapılarak stent trombozu tanısı alan 54 olgu çalışmanın hasta grubunu oluştururken; bunlarla yaş, cinsiyet, koroner risk faktörleri, stent uygulama prosedürü ile stent tipi ve boyu bakımından benzer olup primer PCI sonrası yapılan koroner anjiyografide stenti patent bulunan 147 hasta kontrol grubunu oluşturdu. Toplam 201 hastanın (ortalama yaş 59,8±13,1 yıl, ¾'ü erkek) klinik, hematolojik ve anjiyografik verilerini retrospektif olarak inceledik.Bulgular: İşlem öncesi PLR, stent trombozu gelişen hastalarda gelişmeyenler ile karşılaştıldığında anlamlı olarak daha yüksekti (176±68'e karşı 135±62; p

References

  • Steg PG, James SK, Atar D, Badano LP, Blömstrom-Lundqvist C, Borger MA, et al. Task Force on the management of ST-segment elevation acute myocardial infarction of the ESC, ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 2012;33:2569-619.
  • Dangas GD, Caixeta A, Mehran R, Parise H, Lansky AJ, Cristea E, et al. Frequency and predictors of stent thrombosis after percutaneous coronary intervention in acute myocardial infarction. Circulation 2011;123:1745-56.
  • Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med 2005;352:1685-95.
  • Kaya H, Ertas F, Islamoglu Y, Kaya Z, Atilgan ZA, Cil H, et al. Association Between Neutrophil to Lymphocyte Ratio and Severity of Coronary Artery Disease. Clin Appl Thromb Hemost 2013.
  • Sen N, Afsar B, Ozcan F, Buyukkaya E, Isleyen A, Akcay AB, et al. The neutrophil to lymphocyte ratio was associated with impaired myocardial perfusion and long term adverse outcome in patients with ST-elevated myocardial infarction undergoing primary coronary intervention. Atherosclerosis 2013;228:203-10.
  • Yıldız A, Kaya H, Ertaş F, Oylumlu M, Bilik MZ, Yüksel M, et al Association between neutrophil to lymphocyte ratio and pulmonary arterial hypertension. Türk Kardiyol Dern Arş 2013;41:604-9
  • Akpek M, Kaya MG, Lam YY, Sahin O, Elcik D, Celik T, et al. Relation of neutrophil/lymphocyte ratio to coronary flow to in-hospital major adverse cardiac events in patients with ST-elevated myocardial infarction undergoing primary coronary intervention. Am J Cardiol 2012;110:621-7.
  • Niccoli G, Lanza GA, Spaziani C, Altamura L, Romagnoli E, Leone AM, et al. Baseline systemic inflammatory status and no-reflow phenomenon after percutaneous coronary angioplasty for acute myocardial infarction. Int J Cardiol 2007;117:306-11.
  • Yildiz A, Akil MA, Kayan F, Yuksel M, Bilik MZ, Oylumlu M, et al. Assessment of neutrophil/lymphocyte ratio in patients with myocardial bridge. J Clin Exp Invest 2013.
  • Smith RA, Ghaneh P, Sutton R, Raraty M, Campbell F, Neoptolemos JP. Prognosis of resected ampullary adenocarcinoma by preoperative serum CA19- 9 levels and platelet-lymphocyte ratio. J Gastrointest Surg 2008;12:1422-8.
  • Wang D, Yang JX, Cao DY, Wan XR, Feng FZ, Huang HF, et al. Preoperative neutrophil-lymphocyte and platelet-lymphocyte ratios as independent predictors of cervical stromal involvement in surgically treated endometrioid adenocarcinoma. Onco Targets Ther 2013;6:211-6.
  • Azab B, Shah N, Akerman M, McGinn JT Jr. Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-ST-elevation myocardial infarction. J Thromb Thrombolysis 2012;34:326-34.
  • Acar G, Kalkan ME, Avci A, Alizade E, Tabakci MM, Toprak C, et al. The Relation of Platelet-Lymphocyte Ratio and Coronary Collateral Circulation in Patients With Stable Angina Pectoris and Chronic Total Occlusion. Clin Appl Thromb Hemost 2013.
  • Cutlip DE, Windecker S, Mehran R, Boam A, Cohen DJ, van Es GA, et al. Clinical end points in coronary stent trials: a case for standardized definitions. Circulation 2007;115:2344-51.
  • Leibundgut G, Nietlispach F, Pittl U, Brunner-La Rocca H, Kaiser CA, Pfisterer ME. Stent thrombosis up to 3 years after stenting for ST-segment elevation myocardial infarction versus for stable angina comparison of the effects of drug-eluting versus bare-metal stents. Am Heart J 2009;158:271-6.
  • Kukreja N, Onuma Y, Garcia-Garcia HM, Daemen J, van Domburg R, Serruys PW. The risk of stent thrombosis in patients with acute coronary syndromes treated with bare-metal and drug-eluting stents. J Am Coll Cardiol Intv 2009;2:534-41.
  • Nakazawa G, Finn AV, Joner M, Ladich E, Kutys R, Mont EK, et al. Delayed arterial healing and increased late stent thrombosis at culprit sites after drug- eluting stent placement for acute myocardial infarction patients: an autopsy study. Circulation 2008;118:1138-45.
  • Fujii K, Carlier SG, Mintz GS, Yang YM, Moussa I, Weisz G, et al. Stent underexpansion and residual reference segment stenosis are related to stent thrombosis after sirolimus-eluting stent implantation: an intravascular ultrasound study. J Am Coll Cardiol 2005;45:995-8.
  • Hassan AK, Bergheanu SC, Stijnen T, van der Hoeven BL, Snoep JD, Plevier JW, et al. Late stent malapposition risk is higher after drug-eluting stent compared with bare-metal stent implantation and associates with late stent thrombosis. Eur Heart J 2010;31:1172-80.
  • Nikolsky E, Grines CL, Cox DA, Garcia E, Tcheng JE, Sadeghi M, et al. Impact of baseline platelet count in patients undergoing primary percutaneous coronary intervention in acute myocardial infarction (from the CADILLAC trial). Am J Cardiol 2007;99:1055-61.
  • Zhang SZ, Jin YP, Qin GM, Wang JH . Association of platelet–monocyte aggregates with platelet activation, systemic inflammation, and myocardial injury in patients with non-st elevation acute coronary syndromes. Clin Cardiol 2007;30:26-31
  • Azab B, Torbey E, Singh J, Akerman M, Khoueiry G, McGinn JT, et al. Mean platelet volume/platelet count ratio as a predictor of long-term mortality after non-ST-elevation myocardial infarction. Platelets 2011;22:557-66.
  • Iijima R, Ndrepepa G, Mehilli J, Bruskina O, Schulz S, Schömig A, et al. Relationship between platelet count and 30 day clinical outcomes after percutaneous coronary interventions. Pooled analysis of four ISAR trials. Thromb Haemost 2007;98:852-7.
  • Lordkipanidze M, Diodati JG, Turgeon J, Schampaert E, Palisaitis DA, Pharand C. Platelet count, not oxidative stress, may contribute to inadequate platelet inhibition by aspirin. Int J Cardiol 2010;143:43-50.
  • Furman MI, Benoit SE, Barnard MR, Valeri CR, Borbone ML, Becker RC, et al. Increased platelet reactivity and circulating monocyte-platelet aggregates in patients with stable coronary artery disease. J Am Coll Cardiol 1998;31:352-8.
  • Zouridakis EG, Garcia-Moll X, Kaski JC. Usefulness of the blood lymphocyte count in predicting recurrent instability and death in patients with unstable angina pectoris. Am J Cardiol 2000;86:449-51
  • Ommen SR, Gibbons RJ, Hodge DO, Thomson SP. Usefulness of the lymphocyte concentration as a prognostic marker in coronary artery disease. Am J Cardiol 1997;79:812-4.
  • Ommen SR, Hodge DO, Rodeheffer RJ, McGregor CG, Thomson SP, Gibbons RJ. Predictive power of the relative lymphocyte concentration in patients with advanced heart failure. Circulation 1998;97:19-22.
  • Thomson SP, McMahon LJ, Nugent CA. Endogenous cortisol: a regulator of the number of lymphocytes in peripheral blood. Clin Immunol Immunopathol 1980;17:506-14
  • Raungkaewmanee S, Tangjitgamol S, Manusirivithaya S, Srijaipracharoen S, Thavaramara T. Platelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer. J Gynecol Oncol 2012;23:265-73.
  • Bhatti I, Peacock O, Lloyd G, Larvin M, Hall RI. Preoperative hematologic markers as independent predictors of prognosis in resected pancreatic ductal adenocarcinoma: neutrophil-lymphocyte versus platelet-lymphocyte ratio. Am J Surg 2010;200:197-203.
  • Sunbul M, Gerin F, Durmus E, Kivrak T, Sari I, Tigen K, et al. Neutrophil to lymphocyte and platelet to lymphocyte ratio in patients with dipper versus non-dipper hypertension. Clin Exp Hypertens 2014;36:217-21.
There are 32 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Mustafa Oylumlu This is me

Abdulkadir Yıldız This is me

Murat Yüksel This is me

Ahmet Korkmaz This is me

Mesut Aydın This is me

Mehmet Zihni Bilik This is me

Mehmet Ata Akıl This is me

Sıddık Ülgen This is me

Publication Date February 1, 2013
Published in Issue Year 2014 Volume: 17 Issue: 2

Cite

APA Oylumlu, M. ., Yıldız, A. ., Yüksel, M. ., Korkmaz, A. ., et al. (2013). ST Yükselmeli Miyokard İnfarktüslü Hastalarda Stent Trombozunu Öngörmede Trombosit-Lenfosit Oranının Kullanışlılığı. Koşuyolu Kalp Dergisi, 17(2), 81-85. https://doi.org/10.4274/khj.88597
AMA Oylumlu M, Yıldız A, Yüksel M, Korkmaz A, Aydın M, Bilik MZ, Akıl MA, Ülgen S. ST Yükselmeli Miyokard İnfarktüslü Hastalarda Stent Trombozunu Öngörmede Trombosit-Lenfosit Oranının Kullanışlılığı. Koşuyolu Kalp Dergisi. February 2013;17(2):81-85. doi:10.4274/khj.88597
Chicago Oylumlu, Mustafa, Abdulkadir Yıldız, Murat Yüksel, Ahmet Korkmaz, Mesut Aydın, Mehmet Zihni Bilik, Mehmet Ata Akıl, and Sıddık Ülgen. “ST Yükselmeli Miyokard İnfarktüslü Hastalarda Stent Trombozunu Öngörmede Trombosit-Lenfosit Oranının Kullanışlılığı”. Koşuyolu Kalp Dergisi 17, no. 2 (February 2013): 81-85. https://doi.org/10.4274/khj.88597.
EndNote Oylumlu M, Yıldız A, Yüksel M, Korkmaz A, Aydın M, Bilik MZ, Akıl MA, Ülgen S (February 1, 2013) ST Yükselmeli Miyokard İnfarktüslü Hastalarda Stent Trombozunu Öngörmede Trombosit-Lenfosit Oranının Kullanışlılığı. Koşuyolu Kalp Dergisi 17 2 81–85.
IEEE M. . Oylumlu, A. . Yıldız, M. . Yüksel, A. . Korkmaz, M. . Aydın, M. Z. . Bilik, M. A. . Akıl, and S. . Ülgen, “ST Yükselmeli Miyokard İnfarktüslü Hastalarda Stent Trombozunu Öngörmede Trombosit-Lenfosit Oranının Kullanışlılığı”, Koşuyolu Kalp Dergisi, vol. 17, no. 2, pp. 81–85, 2013, doi: 10.4274/khj.88597.
ISNAD Oylumlu, Mustafa et al. “ST Yükselmeli Miyokard İnfarktüslü Hastalarda Stent Trombozunu Öngörmede Trombosit-Lenfosit Oranının Kullanışlılığı”. Koşuyolu Kalp Dergisi 17/2 (February 2013), 81-85. https://doi.org/10.4274/khj.88597.
JAMA Oylumlu M, Yıldız A, Yüksel M, Korkmaz A, Aydın M, Bilik MZ, Akıl MA, Ülgen S. ST Yükselmeli Miyokard İnfarktüslü Hastalarda Stent Trombozunu Öngörmede Trombosit-Lenfosit Oranının Kullanışlılığı. Koşuyolu Kalp Dergisi. 2013;17:81–85.
MLA Oylumlu, Mustafa et al. “ST Yükselmeli Miyokard İnfarktüslü Hastalarda Stent Trombozunu Öngörmede Trombosit-Lenfosit Oranının Kullanışlılığı”. Koşuyolu Kalp Dergisi, vol. 17, no. 2, 2013, pp. 81-85, doi:10.4274/khj.88597.
Vancouver Oylumlu M, Yıldız A, Yüksel M, Korkmaz A, Aydın M, Bilik MZ, Akıl MA, Ülgen S. ST Yükselmeli Miyokard İnfarktüslü Hastalarda Stent Trombozunu Öngörmede Trombosit-Lenfosit Oranının Kullanışlılığı. Koşuyolu Kalp Dergisi. 2013;17(2):81-5.