New Uses of Platelet-Lymphocyte Ratio for Bleeding Risk Stratification in Patients with Nonvalvular Atrial Fibrillation: A Pilot Study

Yıl 2020, Cilt: 47 Sayı: 1, 24 - 33, 17.03.2020

Kahraman Cosansu Cagın Mustafa Ureyen Harun Kılıc Bilgehan Karadag Aycaturer Cabbar Huseyin Gunduz Ramazan Akdemir

https://doi.org/10.5798/dicletip.705814

Öz

Objective: The primary aim of this study was to investigate the role of platelet-lymphocyte ratio (PLR) to predict bleeding risk in nonvalvular atrial fibrillation (NVAF). Secondary aim was to determine the possible relation between PLR and thromboembolic and bleeding risk scores. Tertiary aim was to evaluate the predictive value of PLR for the patients in the therapeutic international normalized ratio (INR) range.
Method: PLR was calculated from the complete blood count of 228 patients who were under warfarin management for NVAF. The patients were called and it was questioned whether they had experienced the bleeding event within six months after measurement of the PLR values.
Results: Bleeding event was observed in 48 patients after the PLR was calculated. It was found significantly correlation between PLR and CHA2DVAS2C (p<0.01) and HAS-BLED score (p<0,001). The ROC analysis showed that PLR predicted bleeding with a sensitivity of 83% and with a specificity of 84%, using a cut-off value of 165,9. The AUC (area under the curve) for the PLR was found 0.88 (p<0.001). PLR predicted the patients in therapeutic INR range with a sensitivity of 75% at ROC analysis, when using a cut-off value of 125,3 and AUC for the PLR was 0.73 (p<0.001). In the multivariate regression analysis, PLR>165,9 was determined significant indicator for bleeding (p<0.001) and showed more than a 12-fold increased risk of bleeding (12.27, [5.74-26.21]).
Conclusions: The results of the present study indicate that the PLR might be a useful parameter to detect the risk of bleeding. To our knowledge, this is the first study demonstrating the correlation of PLR with both CHA2DS2-VASc and HAS-BLED risk scores. PLR may also predict the patients within the therapeutic INR range.

Anahtar Kelimeler

Platelet-Lymphocyte Ratio, Bleeding Risk

Kaynakça

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