Usefulness of the platelet-to-lymphocyte ratio in predicting long-term cardiovascular mortality in patients with peripheral arterial occlusive disease.
BACKGROUND
Inflammation and increased platelet activation play a crucial role in the initiation and progression of atherosclerosis. Platelet-to-lymphocyte ratio (PLR) has recently been reported as a new independent predictor for major adverse cardiovascular events in cardiovascular diseases.


OBJECTIVE
To investigate the relation between PLR and cardiovascular mortality in patients with intermittent claudication or critical limb ischemia (CLI) or both.


METHODS
In our retrospective study, 602 consecutive patients who were admitted to a large tertiary hospital with the diagnosis of symptomatic peripheral arterial occlusive disease (PAOD) were included. Patients were divided into two groups according to their PLR as follows: high PLR (PLR > 142) and low PLR (PLR ≤ 142) groups.


RESULTS
During the follow-up period (median: 33.8 months (interquartile range: 21-45)), 131 deaths occurred out of 602 (21.8%) patients. Cardiovascular mortality was found to be significantly higher in the high PLR group compared to the low PLR group (31.6% vs. 17.2 %;p< 0.001). Even after adjustment for various risk factors, PLR > 142 and age were found to be independent predictors of long-term cardiovascular mortality in Cox regression analysis (hazard ratios (95% confidence interval): 1.03 (1.01-1.04) and 1.04 (1.02-1.06),p< 0.001 andp< 0.001, respectively).


CONCLUSIONS
Platelet-to-lymphocyte ratio, which is one of the parameters of routine complete blood count, reflects increased inflammatory status, platelet activation and aggregation. PLR is a cheap and readily available marker that has the ability to improve risk stratification provided by conventional risk scores in predicting long-term cardiovascular mortality in PAOD.
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey.
Fatih
F
Uzun
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey.
Mehmet
M
Erturk
Department of Cardiology, Mustafakemalpasa State Hospital, Bursa, Turkey.
Huseyin Altug
HA
Cakmak
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey.
Ali Kemal
AK
Kalkan
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey.
Ibrahim Faruk
IF
Akturk
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey.
Ahmet Arif
AA
Yalcin
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey.
Begum
B
Uygur
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey.
Umit
U
Bulut
Department of Cardiovascular Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Training Hospital, Istanbul, Turkey.
Kursat
K
Oz
cardiovascular mortality; peripheral arterial occlusive disease; platelet-to-lymphocyte ratio