title: Platelet/lymphocyte ratio was associated with impaired myocardial perfusion and both in-hospital and long-term adverse outcome in patients with ST-segment elevation acute myocardial infarction undergoing primary coronary intervention.
abstract: BACKGROUND
  Platelet/lymphocyte ratio (PLR) has been shown to be an inflammatory and thrombotic biomarker for coronary heart disease, but its prognostic value in ST-segment elevation myocardial infarction (STEMI) has not been fully investigated.
  
  
  OBJECTIVE
  To investigate the relationship between PLR and no-reflow, along with the in-hospital and long-term outcomes in patients with STEMI.
  
  
  METHODS
  In the present study, we included 304 consecutive patients suffering from STEMI who underwent primary percutaneous coronary intervention (p-PCI). Patients were stratified according to PLR tertiles based on the blood samples obtained in the emergency room upon admission. No-reflow after p-PCI was defined as a coronary thrombolysis in myocardial infarction (TIMI) flow grade ≤ 2 after vessel recanalization, or TIMI flow grade 3 together with a final myocardial blush grade (MBG) < 2.
  
  
  RESULTS
  The mean follow-up period was 24 months (range: 22-26 months). The number of patients characterized with no-reflow was counted to depict increments throughout successive PLR tertiles (14% vs. 20% vs. 45%, p < 0.001). In-hospital major adverse cardiovascular events and death increased as the PLR increased (p < 0.001, p < 0.001). Long-term MACE and death also increased as the PLR increased (p < 0.001, p < 0.001). Multivariable logistic regression analysis revealed that PLR remained an independent predictor for both in-hospital (OR = 1.01, 95% CI: 1.00-1.01; p = 0.002) and major long-term (OR = 1.01, 95% CI: 1.00-1.01; p < 0.001) adverse cardiac events.
  
  
  CONCLUSIONS
  Platelet/lymphocyte ratio on admission is a strong and independent predictor of both the no-reflow phenomenon and long-term prognosis following p-PCI in patients with STEMI.
authors.affiliation: Kosuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Toprak
authors.affiliation: Kosuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mehmet M
authors.initials: MM
authors.lastname: Tabakci
authors.affiliation: Kosuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: Zeki
authors.initials: Z
authors.lastname: Simsek
authors.affiliation: Kosuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ugur
authors.initials: U
authors.lastname: Arslantas
authors.affiliation: Department of Cardiology, Tavsanli Doc. Dr. Mustafa Kalemli State Hospital, Kutahya, Turkey.
authors.forename: Halil I
authors.initials: HI
authors.lastname: Durmus
authors.affiliation: Kosuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: Lutfi
authors.initials: L
authors.lastname: Ocal
authors.affiliation: Kosuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: Muhittin
authors.initials: M
authors.lastname: Demirel
authors.affiliation: Kosuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Ozturkeri
authors.affiliation: Cardiology Clinic, Pendik State Hospital, Istanbul, Turkey.
authors.forename: Ender
authors.initials: E
authors.lastname: Ozal
authors.affiliation: Kosuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Kargin
keywords: ST-segment elevation acute myocardial infarction; in-hospital mortality; long-term mortality; no-reflow; platelet/lymphocyte ratio