Yayla Çağrı, Akboğa Mehmet Kadri, Canpolat Uğur, Akyel Ahmet, Yayla Kadriye Gayretli, Doğan Mehmet, Yeter Ekrem, Aydoğdu Sinan
Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey.
Angiology. 2015 Oct;66(9):831-6. doi: 10.1177/0003319715573658. Epub 2015 Feb 24.
Patency of infarct-related artery (IRA) in patients with ST-segment elevation myocardial infarction (STEMI) before primary percutaneous coronary intervention (pPCI) is associated with lower mortality and better clinical outcome. However, there were little data regarding the predictors of IRA patency before pPCI in the setting of STEMI. We aimed to assess the association of platelet to lymphocyte ratio (PLR) with IRA patency in STEMI. A total of 452 patients were enrolled and categorized as occluded or patent IRA. Patency IRA was assessed by the thrombolysis in myocardial infarction (TIMI) flow grade. Blood samples were obtained on admission to calculate PLR. Of all patients, 92 (20.4%) patients revealed pre-pPCI TIMI 3 flow in IRA. The PLR was significantly higher in occluded IRA group (138.4 ± 51.4 vs 95.4 ± 43.5, P < .001). Glucose, troponin I, and neutrophil to lymphocyte ratio (NLR) levels were also higher in occluded IRA group (P < .05). Multivariate regression analysis demonstrated the PLR (odds ratio [OR]: 0.987; 95% confidence interval [CI]: 0.978-0.995, P = .002) and NLR (OR: 0.758; 95% CI: 0.584-0.985, P = .038) on admission as independent predictors of IRA patency. In conclusion, a higher PLR is a powerful and independent predictor of IRA patency in patients with STEMI before pPCI.
ST段抬高型心肌梗死（STEMI）患者在接受直接经皮冠状动脉介入治疗（pPCI）前，梗死相关动脉（IRA）的通畅情况与较低的死亡率及更好的临床结局相关。然而，关于STEMI患者在pPCI前IRA通畅的预测因素的数据较少。我们旨在评估血小板与淋巴细胞比值（PLR）与STEMI患者IRA通畅情况之间的关联。共纳入452例患者，并根据IRA是否闭塞进行分类。通过心肌梗死溶栓（TIMI）血流分级评估IRA的通畅情况。入院时采集血样以计算PLR。在所有患者中，92例（20.4%）患者在pPCI前显示IRA的TIMI 3级血流。闭塞IRA组的PLR显著更高（138.4±51.4 vs 95.4±43.5，P<.001）。闭塞IRA组的血糖、肌钙蛋白I和中性粒细胞与淋巴细胞比值（NLR）水平也更高（P<.05）。多因素回归分析表明，入院时的PLR（比值比[OR]：0.987；95%置信区间[CI]：0.978 - 0.995，P = .002）和NLR（OR：0.758；95% CI：0.584 - 0.985，P = .038）是IRA通畅的独立预测因素。总之，较高的PLR是STEMI患者在pPCI前IRA通畅的有力且独立的预测因素。
