Patients with acute coronary syndromes exhibit a wide spectrum of early risk of death (1–10%). High platelet counts may indicate a propensity for platelet-rich thrombi. A low lymphocyte count has been linked to poor general health. Combining these two markers, recent studies have found that the platelet-to-lymphocyte ratio (PLR) is associated with adverse cardiac events among patients with ACS, but local data is limited. We aim to determine if an elevated PLR taken on admission is associated with higher rates of adverse cardiac events.Design and Method:
A retrospective cohort of adult patients with ACS admitted at the UP-Philippine General Hospital was analyzed. Leukocyte and platelet counts were measured by an automated hematology analyzer. The PLR of these patients was computed, and they were stratified into two groups after determining the optimal cut-off from the receiver operating characteristic curve (ROC) curve. The primary outcome was in-hospital mortality. Secondary outcomes include development or worsening of heart failure, and the development of cardiogenic shock, reinfarction, and significant arrhythmias.Results:
A total of 174 Filipinos with ACS were included. In-hospital mortality occurred in 30 patients (17%). These patients had a higher PLR compared to those who were discharged alive (p-value < 0.0001). The optimal cutoff value of PLR to predict in-hospital mortality is 165, with a sensitivity of 77% and specificity of 70% (area under the ROC curve of 0.766). On multiple logistic regression analysis, a high PLR was an independent predictor of in-hospital mortality (RR 8.52; p 0.003) after controlling for the effect of other variables.Conclusions:
Among Filipino patients with ACS, an elevated PLR taken within 24 hours of presentation is a useful marker to predict in-hospital mortality, thus providing useful information for risk stratification.