Systemic Inflammatory Index and Platelet-to-Lymphocyte Ratio Predicted Mortality in patients with Acute Myocardial Infarction

Öz

In this study, we aimed to evaluate the relationship between the laboratory parameters of platelet volume / lymphocyte ratio (PLR) and systemic inflammatory index (SII) with prognosis and mortality in patients with hospitalized GFR (Glomerular filtration rate) <60 and a diagnosis of acute myocardial infarction (AMI). This study was designed as a retrospective cohort study. 235 myocardial infarction (MI) patients over the age of 18 and with GFR <60, hospitalized in our hospital between January 01, 2016 and January 01, 2019, were included in the study. The patients were divided into 2 groups as survive and mortality. The two groups were compared in terms of demographic characteristics, clinical data (symptoms, comorbidities, laboratory findings, GFR, coronary angiography, drugs used and complications in patients. Platelet - lymphocyte ratio (PLR) was found by dividing platelet count by lymphocyte count. Systemic inflammatory index (SII) was found by multiplying neutrophil count and PLR value. The average age of the survive was 67.1±12,8 (32-101). In the mortality group, the mean age was 69.55±11,1 (46-100). PLR and SII levels were statistically significantly higher in the mortality group compared to the survive group (p=0.002, p=0.029, respectively). According to the results of ROC analysis in patients with mortality, sensitivity 59.1% and specificity 70.4% for PLR (p=0.002); sensitivity 54.5% and specificity 60.9% for SII (p=0.029). The risk factors found to be significantly associated with mortality in the regression analysis included PLR (β: 0.007, OR (95% CI): 1.007 (1.001-1.012), p=0.001) and SII (β: 0.001, OR (95% CI): 1.000 (0.999-1.001), p=0.041). As inexpensive and easily available new inflammatory markers, PLR and SII were significantly higher in patients with GFR <60 and died from acute myocardial infarction (AMI). In addition, PLR and SII were able to predict the mortality from myocardial infarction.

Anahtar Kelimeler

• Acute myocardial infarction
• Mortality
• Platelet - lymphocyte ratio
• Systemic inflammatory index

Kaynakça

1. 1. Carrabba M, Madeddu P. Current Strategies for the Manufacture of Small Size Tissue Engineering Vascular Grafts. Front Bioeng Biotechnol. 2018;6:41.
2. 2. Onat A, Dursunoglu D, Bulur S, Kucukdurmaz Z, Kaya Z, Ordu S, et al. [Turkish Adult Risk Factor Survey 2007: decline in all-cause and coronary mortality continues]. Turk Kardiyol Dern Ars. 2008;36(2):77-81.
3. 3. Yurtdas M, Ozdemir M, Aladag N. Kompanse Kalp Yetmezligi Olan Hastalarda Notrofil-Lenfosit Orani, Trombosit-Lenfosit Orani ve Ortalama Trombosit Hacminin Arastirilmasi/Investigation of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio and Mean Platelet Volume in Patients with Compensated Heart Failure. Journal of Academic Research in Medicine. 2018;8(2):67-72.
4. 4. Budzianowski J, Pieszko K, Burchardt P, Rzezniczak J, Hiczkiewicz J. The Role of Hematological Indices in Patients with Acute Coronary Syndrome. Dis Markers. 2017;2017:3041565.
5. 5. Yang YL, Wu CH, Hsu PF, Chen SC, Huang SS, Chan WL, et al. Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Invest. 2020;50(5):e13230.
6. 6. Durmus E, Kivrak T, Gerin F, Sunbul M, Sari I, Erdogan O. Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio are Predictors of Heart Failure. Arq Bras Cardiol. 2015;105(6):606-13.
7. 7. Yildiz A, Yuksel M, Oylumlu M, Polat N, Akyuz A, Acet H, et al. The Utility of the Platelet-Lymphocyte Ratio for Predicting No Reflow in Patients With ST-Segment Elevation Myocardial Infarction. Clin Appl Thromb Hemost. 2015;21(3):223-8.
8. 8. Oylumlu M, Yildiz A, Oylumlu M, Yuksel M, Polat N, Bilik MZ, et al. Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome. Anatol J Cardiol. 2015;15(4):277-83.

9. 9. Mirza AJ, Taha AY, Khdhir BR. Risk factors for acute coronary syndrome in patients below the age of 40 years. Egypt Heart J. 2018;70(4):233-5.
10. 10. 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(4):449-51.
11. 11. 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(6):812-4.
12. 12. Luke K, Purwanto B, Herawati L, Al-Farabi MJ, Oktaviono YH. Predictive Value of Hematologic Indices in the Diagnosis of Acute Coronary Syndrome. Open Access Maced J Med Sci. 2019;7(15):2428-33.
13. 13. 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(3):326-34.
14. 14. Sun XP, Li J, Zhu WW, Li DB, Chen H, Li HW, et al. Impact of Platelet-to-Lymphocyte Ratio on Clinical Outcomes in Patients With ST-Segment Elevation Myocardial Infarction. Angiology. 2017;68(4):346-53.
15. 15. Dick SA, Epelman S. Chronic Heart Failure and Inflammation: What Do We Really Know? Circ Res. 2016;119(1):159-76.
16. 16. Multhoff G, Molls M, Radons J. Chronic inflammation in cancer development. Front Immunol. 2011;2:98.
17. 17. Hotamisligil GS. Inflammation and metabolic disorders. Nature. 2006;444(7121):860-7.
18. 18. Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res. 2014;20(23):6212-22.
19. 19. Seo M, Yamada T, Morita T, Furukawa Y, Tamaki S, Iwasaki Y, et al. P589 Prognostic value of systemic immune-inflammation index in patients with chronic heart failure. European Heart Journal. 2018;39(suppl_1):ehy564. P89.