Novel predictors of infarct-related artery patency for ST-segment elevation myocardial infarction: Platelet-to-lymphocyte ratio, uric acid, and neutrophil-to-lymphocyte ratio

Halit Acet, Faruk Ertaş, Mehmet Ata Akıl, Ferhat Özyurtlu, Abdülkadir Yıldız, Nihat Polat, Mehmet Zihni Bilik, Mesut Aydın, Mustafa Oylumlu, Hasan Kaya, Murat Yüksel, Abdurrahman Akyüz, Hilal Ayçiçek, Sait Alan, Nizamettin Toprak
Anatolian Journal of Cardiology 2015, 15 (8): 648-56

OBJECTIVE: The neutrophil/lymphocyte ratio (NLR), the platelet/lymphocyte ratio (PLR), and uric acid (UA) are inflammatory markers in cardiovascular disease. However, there are not enough data on infarct-related artery (IRA) patency in ST-segment elevation myocardial infarction (STEMI). We aimed to investigate the association of NLR, PLR, and UA with IRA patency before percutaneous coronary intervention (PCI) in STEMI.

METHODS: The study was designed as a retrospective study. Three hundred and twenty-four consecutive patients with STEMI were divided into two groups according to pre-PCI Thrombolysis in Myocardial Infarction flow grade (TIMI). Patients with a TIMI flow grade of into the spontaneous reperfusion (SR) group, while patients with TIMI flow grade of 0, 1 and 2 were placed into the non-SR group. The χ2 and independent-samples t-test, Mann-Whitney U test, multivariate logistic regression analysis, and receiver-operator characteristic (ROC) curve analysis were used for the statistical analysis.

RESULTS: PLR, NLR, and UA values in the SR group were lower than in the non-SR group (p<0.004, p<0.001, p<0.001, respectively). In the multivariate analysis, serum UA level and PLR were found to be independent predictors of pre-PCI IRA patency. In the ROC curve analysis, PLR >190, UA>5.75 mg/dL, and NLR>4.2 predicted non-SR. The sensitivity and specificity of the association between low IRA TIMI flow grade and PLR were 88% and 84%, 72% and 66% for UA, and 74% and 44% for NLR, respectively.

CONCLUSION: We determined that PLR and UA are novel predictors of IRA patency before PCI. We suggest that PLR and UA may be used in risk-stratifying STEMI.


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