title: Platelet-to-Lymphocyte Ratio Improves the Predictive Power of GRACE Risk Score for Long-Term Cardiovascular Events in Patients with Acute Coronary Syndrome.
abstract: OBJECTIVE
  This study aims to evaluate the relationship between platelet-to-lymphocyte ratio (PLR) and GRACE risk score and to examine whether PLR on admission can improve the predictive value of GRACE risk score for cardiovascular disease (CVD) events in patients with acute coronary syndrome (ACS).
  
  
  METHODS
  PLR was calculated from the platelet and lymphocyte counts from the complete blood count of 2,230 ACS patients upon admission. The GRACE risk score was also calculated.
  
  
  RESULTS
  Spearman's rank correlation demonstrated that GRACE risk score was positively correlated with PLR (r = 0.190, p < 0.001). After a median follow-up period of 58 months, multivariate Cox analysis showed that both GRACE risk score [hazard ratio (HR) 1.092, 95% confidence interval (CI) 1.067-1.117, p < 0.001] and PLR (HR 1.100, 95% CI 1.088-1.112, p < 0.001) could independently predict CVD events. Receiver-operating characteristic curve (ROC) analysis proved that using PLR together with GRACE risk score improved the score from 0.70 (95% CI 0.67-0.73, p < 0.001) when used alone to 0.81 (95% CI 0.79-0.83, p < 0.001) for CVD events and from 0.73 (95% CI 0.70-0.77, p < 0.001) when used alone to 0.80 (95% CI 0.77-0.83, p < 0.001) for all-cause mortality.
  
  
  CONCLUSIONS
  This study proves, for the first time, a positive association between GRACE risk score and PLR, and that a combination of PLR and GRACE risk score is more effective in predicting CVD events in ACS patients.
authors: Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, PR China.
authors: Dong
authors: D
authors: Zhou
authors: Yan
authors: Y
authors: Fan
authors: Zhaofei
authors: Z
authors: Wan
authors: Wen
authors: W
authors: Wen
authors: Xinhong
authors: X
authors: Wang
authors: Juan
authors: J
authors: Zhou
authors: Tao
authors: T
authors: Chen
authors: Zuyi
authors: Z
authors: Yuan
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D000368:Aged; D001792:Blood Platelets; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012372:ROC Curve; D012107:Research Design; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013995:Time