Diagnostic Accuracy of Platelet/Lymphocyte Ratio for Screening Complex Coronary Lesion in Different Age Group of Patients with Acute Coronary Syndrome (original) (raw)
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Journal of Cardiovascular Diseases & Diagnosis
Background: Increasing of ACS case with complex coronary lesion and in increase needs of CABG, we need tools to help in stratification of high risk patient that can be used in daily clinical practice, and even can be used in first line of health care facilities in Indonesia. By doing early stratification of high risk patient, hopefully it can decrease the morbidity and mortality in ACS cases. Aim: Evaluate diagnostic accuracy of PLR in identifying a complex coronary lesion and optimal cutoff point of PLR between ≤ 45 years old group and >45 years old group subjects. Method: This is a cross sectional study which was conducted retrospectively in ACS patients from January 2012 until July 2015. The inclusion criteria are adult ACS patients (age ≥18 years old) diagnosed with ACS and who underwent coronary angiography during hospitalization. The diagnostic accuracy was determined by calculating the sensitivity, specificity, Positive Likelihood Ratio (LR+), and Negative Likelihood Ratio (LR-). The cutoff point was determined using ROC curve. Results: The proportion of complex coronary lesion in this study was 47.2%. The optimal cutoff point in ≤ 45 year's old group was 111.06 with sensitivity, specificity, LR+, and LR─ respectively 91.3%, 91.9%, 11.27 and 0.09. The optimal cutoff points in >45 years old groups was 104,78 with sensitivity, specificity, LR+, and LR─ respectively 91.7%, 58.6%, 2.21 and 0.14. Conclusion: The optimal cutoff point of ≤ 45 years old groups is 111.06 and for >45 years old group is 104.78 with AUC 93.9% (p<0.001) 77.3% (p<0.001), respectively.
Philippine Journal of Pathology, 2016
Introduction. Mean platelet volume (MPV), an index for platelet size, is believed to be associated with acute coronary syndromes (ACS). This study aims to establish the association of MPV and ACS in the local setting and to further evaluate the diagnostic accuracy of MPV in the detection of ACS. Methodology. Adult patients presenting with chest pain seen at the ER were submitted for complete blood count (CBC). Specimens were processed for MPV and platelet count using Beckman-Coulter ACT 5Diff hematology auto-analyzer. Patients were grouped into ACS and non-ACS. Independent t-test was used for analysis. Diagnostic cutoff point was determined using Receiver Operating Characteristic (ROC) Curve. Results. A total of 150 adult patients was examined for MPV and platelet counts. There was a significant difference of MPV between the two groups (p value <0.0001). The MPV of patients with ACS was increased at 8.3 fL compared to 7.3 fL in patients not diagnosed with ACS. At cutoff point of 8.4 fL, the positive predictive value and specificity for ACS were 100%, sensitivity of 43.6 and a negative predictive value of 46.2. The number of platelets was increased in non-ACS group. Conclusion. The MPV of acute chest patients diagnosed with ACS was significantly higher compared to patients not diagnosed with ACS. Increased MPV at 8.4 fL was highly specific and predictive of ACS. However, the sensitivity and negative predictive value were low. The platelet count of non-ACS group was increased.
Platelet Distribution Width Value as a Diagnostic and Prognostic Marker in Acute Coronary Syndrome
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY
An acute coronary syndrome is a form of clinical manifestation of coronary heart disease with atherosclerosis, and thrombosis processes. Platelets play an essential role in thrombosis. High PDW shows a variation of the morphology, and size of a platelet. This was a retrospective cross-sectional study comparing PDW, length of stay, and patient outcome in STEMI, NSTEMI, UAP, and control patients at the Dr.Wahidin Sudirohusodo Hospital Makassar during the period of January 2014 – December 2015. Data were analyzed using statistical software. One hundred, and seventy-two ACS patients were included; 65 patients had UAP, 48 patients had STEMI and 59 patients had NSTEMI. Sixty normal patients were included as a control. Kruskal-Wallis test showed a statistical difference in PDW between patients with STEMI, NSTEMI, UAP, and control (p=0.000). Post hoc test showed a significant difference between ACS, and control, STEMI, and control (p=0.000), NSTEMI and control (p=0.000), UAP, and control (p...
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY, 2018
Sindrom Koroner Akut (SKA) merupakan puncak manifestasi klinis aterosklerosis di arteri koroner. Inflamasi terjadi dari tahapawal pembentukan ateroma sampai ruptur plak dan trombosis. Trombosis memainkan peran penting dalam perjalanan penyakit SKA.Trombositosis dan limfopenia berhubungan dengan derajat inflamasi sistemik dan Rasio Platelet Limfosit (PLR) menjadi petanda baruyang melibatkan kedua tolok ukur hematologi tersebut. Penelitian ini merupakan penelitian retrospektif di Rumah sakit Dr. WahidinSudirohusodo Makassar dengan mengambil data pasien SKA UAP, STEMI, NSTEMI dan menilai PLR dari pemeriksaan darah rutin saatmasuk Rumah sakit. Data PLR dibandingkan berdasarkan jenis SKA, kemudian dibandingkan dengan kontrol sehat. Hasil penelitiandidapatkan 223 data pasien SKA UAP, STEMI dan NSTEMI masing-masing 89, 68, 66 data dan kontrol normal 198 data. Hasil ujistatistik Kruskal wallis menunjukkan perbedaan bermakna PLR antara pasien UAP, NSTEMI dan STEMI (p=0,011). Hasil uji post h...
The American journal of cardiology, 2014
The SYNTAX score (SXscore) is an anatomic scoring system based on coronary angiography (CA) that not only quantifies lesion severity and complexity but also predicts poor cardiovascular outcomes, including mortality, in patients with acute coronary syndromes (ACS). Recent studies have shown that platelet-to-lymphocyte ratio (PLR) is associated with worse outcomes in many cardiovascular diseases. The aim of this study was to investigate the association of PLR with the severity and complexity of coronary atherosclerosis as assessed by the SXscore in patients with ACS who underwent urgent CA. A total of 1,016 patients with ACS who underwent urgent CA were included in the study from August 2012 to March 2014. Admission PLR values were calculated before CA was performed. The SXscore was determined from baseline CA. The patients were divided into 2 groups, those with low SXscores (≤22) and those with intermediate to high SXscores (≥23). PLRs were significantly higher in patients with inte...
Journal of Babol University of Medical Sciences, 2020
BACKGROUND AND OBJECTIVE: The platelet-to-lymphocyte ratio (PLR) might be an important and critical measure in evaluating and anticipating undesirable outcomes in patients with acute coronary syndrome (ACS). What was discussed in this study was systemic evaluation of the role of PLR in predicting adverse outcomes of ACS (including mortality and MACE) both in the short term and in the long term. METHODS: In this systematic review, studies related to platelet counts, lymphocytes, acute coronary artery syndrome were searches in Medline, Web of knowledge, Google scholar, Scopus, and Cochrane databases. Finally, 15 related studies were reviewed, including 7 prospective studies and 8 retrospective studies. FINDINGS: In a review of 15 articles, a total of 8304 patients in the group with low PLR and 5822 patients in the group with high PLR were considered. The increase in PLR can increase the risk of short-term and long-term mortality by 0.3 and 1.8 times, respectively. CONCLUSION: Based on the results of this study, the increase in PLR can effectively predict early and long term adverse events in patients with ACS.
Immature Platelet Fraction as A Potential Marker To Differentiate Types of Acute Coronary Syndrome
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY
Acute Coronary Syndrome (ACS) includes ST-Elevation Myocardial Infarction (STEMI), non-ST Elevation MyocardialInfarction (NSTEMI), and Unstable Angina (UA). Platelet plays an essential role in ACS pathogenesis. Immature PlateletFraction (IPF) and platelet indices can predict platelet activations. Platelet indices consist of platelet count, Mean PlateletVolume (MPV), Platelet Distribution Width (PDW), plateletcrit (Pct). This study aimed to analyze the differences of IPF andplatelet indices among ACS patients. This study was an observational analytical cross-sectional study conducted inDr. Soetomo Hospital during May-September 2019. The subjects consisted of 30-STEMI, 25-NSTEMI, and 24-UA patients.The EDTA-samples were measured for platelet indices and IPF using Sysmex XN-1000. The differences between IPF andplatelet indices among STEMI, NSTEMI, and UA patients were analyzed using Kruskal-Wallis and Mann-Whitney test. The IPFvalues were significantly higher in STEMI patients than NST...
Platelet Distribution width is an Early Indicator of Acute Coronary Syndrome
University Heart Journal, 2014
Objective: This cross sectional study was conducted in the dept. of clinical pathology in collaboration with dept. of cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU) and Bangladesh Institute of Research & Rehabilitation of Diabetes Endocrine and Metabolic Disorders (BIRDEM) to evaluate the role of platelet distribution width (PDW) in diagnosing acute coronary syndrome (ACS). Patients & Methods: A total of 142 patients were selected for the study. Of them 79 were cases (patients with acute coronary syndrome) and 63 were controls (patients with non cardiac chest pain). The cardiologist established the diagnosis by clinical examination, ECG and biochemical markers especially troponin I. A structured questionnaire was used which addressed all the variables of interest. Blood samples of the selected patients were taken to investigate their platelet distribution width level and to find its association with ACS. The blood samples was taken properly and processed in a Haemat...
Panacea Journal of Medical Sciences
Platelets have a major role in acute coronary syndrome and their activation is a hallmark of this. Troponin I, Troponin T and Creatine Kinase enzymes are not enough sensitive at an early stage of acute coronary syndrome. Platelet indices can be detected earlier, inexpensive, widely available and easily recordable in most clinical laboratories, thus could be a better marker in these patients. The primary objective of this study is to determine the correlation between platelet indices and spectrums of acute coronary syndrome or the number of vessels involved. This is a prospective observation study conducted in a tertiary care teaching hospital of eastern India over a period of six months where 125 patients were non-randomly selected with a diagnosis of acute coronary syndrome who underwent coronary angiogram and reports correlated with platelet parameters. A total of 100 patients were finally evaluated. Only platelet large cell ratio and platelet-crit were significantly higher in ST ...