Tangshan Gongren Hospital, Tangshan, Hebei, China.
Aging Clin Exp Res. 2021 Mar;33(3):619-624. doi: 10.1007/s40520-020-01555-7. Epub 2020 Apr 16.
The platelet to lymphocyte ratio (PLR) is a novel biomarker to predict the prognosis of acute myocardial infarction (AMI) patients.
The study aimed to evaluate the in-hospital outcomes of elderly patients with AMI and assessed the prognostic value of PLR on in-hospital adverse events.
A total of 1,001 patients were divided into an older group (n = 560) and a younger group (n = 441) based on age ≥ 60 years and successfully underwent primary percutaneous coronary intervention (PCI) within 12 h after presentation. Total white blood cells (WBCs), neutrophils, lymphocytes, and platelets counts were measured at admission.
The incidence of heart rupture, acute heart failure, total adverse events, and death resulting from all events were significantly higher in patients ≥ 60 years than in younger patients, whereas the incidence of postoperative angina and reinfarction were similar between groups. Regarding blood counts, total white blood cells, neutrophils, lymphocytes, and platelets were lower in the older group than in the younger group. The platelet-to-lymphocyte ratio (PLR) was significantly higher in the older group. In receiver operating characteristic curve analysis, high PLR > 147 predicted adverse events (specificity 72% and sensitivity 63%). In multiple logistic regression analysis, age, hypertension, and PLR were identified as independent predictors of adverse events.
The in-hospital outcomes of elderly patients with acute myocardial infarction were poor. PLR was an independent risk factor for in-hospital adverse events, which suggested that strong inflammation and prothrombotic status may contribute to the poor prognoses of elderly patients.
血小板与淋巴细胞比值（PLR）是预测急性心肌梗死（AMI）患者预后的一种新的生物标志物。
本研究旨在评估老年 AMI 患者的住院结局，并评估 PLR 对住院不良事件的预后价值。
根据年龄≥60 岁将 1001 例患者分为老年组（n=560）和年轻组（n=441），并在发病后 12 小时内成功接受了经皮冠状动脉介入治疗（PCI）。入院时测量总白细胞（WBC）、中性粒细胞、淋巴细胞和血小板计数。
≥60 岁患者心脏破裂、急性心力衰竭、总不良事件以及所有事件导致的死亡发生率明显高于年轻患者，而术后心绞痛和再梗死发生率在两组间相似。在血液计数方面，老年组的总白细胞、中性粒细胞、淋巴细胞和血小板均低于年轻组。老年组的血小板与淋巴细胞比值（PLR）明显较高。在受试者工作特征曲线分析中，高 PLR＞147 预测不良事件（特异性为 72%，敏感性为 63%）。多因素 logistic 回归分析显示，年龄、高血压和 PLR 是不良事件的独立预测因素。
老年急性心肌梗死患者的住院结局较差。PLR 是住院不良事件的独立危险因素，这表明强烈的炎症和促血栓形成状态可能导致老年患者预后不良。
