title: Usefulness of the platelet-to-lymphocyte ratio in predicting angiographic reflow after primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction.
abstract: Impaired coronary flow after primary percutaneous coronary intervention (PPCI) is associated with short- and long-term morbidity and mortality in patients with acute ST-segment elevation myocardial infarction (STEMI). Recent studies have demonstrated that platelet-to-lymphocyte ratio (PLR) is associated with adverse cardiovascular outcomes. The aim of this study was to assess the relation between admission PLR and angiographic reflow after PPCI. A total of 520 patients with acute STEMI (age 60 ± 13 years; 74% men) occurring within 12 hours of the onset of symptoms who underwent PPCI were enrolled. The PLR and other laboratory parameters were measured before PPCI. The patients were divided into 2 groups based on the postintervention Thrombolysis in Myocardial Infarction (TIMI) flow grade: normal-reflow group (defined as postintervention TIMI grade 3 flow) and none-reflow group (consisted of both patients with angiographic no-reflow defined as postintervention TIMI grades 0 to 1 flow and slow flow defined as postintervention TIMI grade 2 flow). There were 117 patients (22.5%) in the none-reflow group (age 68 ± 13 years and 77% men) and 403 patients in the normal-reflow group (age 58 ± 12 years and 63% men). The none-reflow group had significantly higher PLR compared with the normal-reflow group (219 ± 79 vs 115 ± 59, p <0.001). In logistic regression analysis, PLR (odds ratio 1.818, 95% confidence interval 1.713 to 1.980, p <0.001) and total stent length (OR 1.052, confidence interval 1.019 to 1.086, p = 0.002) were independent predictors of none-reflow after PPCI. In conclusion, preintervention PLR is a strong and independent predictor of slow flow/no-reflow after PPCI in patients with acute STEMI.
authors.affiliation: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey. Electronic address: alpkurtul@yahoo.com.
authors.forename: Alparslan
authors.initials: A
authors.lastname: Kurtul
authors.affiliation: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: Mikail
authors.initials: M
authors.lastname: Yarlioglues
authors.affiliation: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: Sani Namik
authors.initials: SN
authors.lastname: Murat
authors.affiliation: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Ergun
authors.affiliation: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Duran
authors.affiliation: Department of Cardiology, Faculty of Medicine, Yıldırım Beyazıt University, Ankara, Turkey.
authors.forename: Haci Ahmet
authors.initials: HA
authors.lastname: Kasapkara
authors.affiliation: Department of Cardiology, Faculty of Medicine, Turgut Ozal University, Ankara, Turkey.
authors.forename: Muhammed Bora
authors.initials: MB
authors.lastname: Demircelik
authors.affiliation: Department of Cardiology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cetin
authors.affiliation: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: Adil Hakan
authors.initials: AH
authors.lastname: Ocek
mesh_terms: D000368:Aged; D001792:Blood Platelets / Q000473:pathology*; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000000981:diagnostic imaging / Q000601:surgery; D054318:No-Reflow Phenomenon / Q000097:blood / Q000000981:diagnostic imaging* / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention; D010976:Platelet Count; D011183:Postoperative Complications; D011184:Postoperative Period; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology