Medical I Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Surgery II Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Medicina (Kaunas). 2022 Jun 16;58(6):814. doi: 10.3390/medicina58060814.
Background and Objectives: Functional capacity (FC) assessed via cardiopulmonary exercise testing (CPET) is a novel, independent prognostic marker for patients with coronary artery disease (CAD). Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are two readily available predictors of systemic inflammation and cardiovascular event risk, which could be used as cost-effective predictors of poor FC. The purpose of this study was to evaluate the utility of NLR and PLR in predicting poor FC in patients with CAD and recent elective percutaneous coronary intervention (PCI). Materials and Methods: Our cross-sectional retrospective analysis included 80 patients with stable CAD and recent elective PCI (mean age 55.51 ± 11.83 years, 71.3% male) who were referred to a cardiovascular rehabilitation center from January 2020 to June 2021. All patients underwent clinical examination, cardiopulmonary exercise testing on a cycle ergometer, transthoracic echocardiography and standard blood analysis. Results: Patients were classified according to percent predicted oxygen uptake (% VO2 max) in two groups—poor FC (≤70%, n = 35) and preserved FC (>70%, n = 45). There was no significant difference between groups regarding age, gender ratio, presence of associated comorbidities, left ventricular ejection fraction and NLR. PLR was higher in patients with poor FC (169.8 ± 59.3 vs. 137.4 ± 35.9, p = 0.003). A PLR cut-off point of 139 had 74% sensitivity and 60% specificity in predicting poor FC. After multivariate analysis, PLR remained a significant predictor of poor functional status. Conclusions: Although CPET is the gold standard test for assessing FC prior to cardiovascular rehabilitation, its availability remains limited. PLR, a cheap and simple test, could predict poor FC in patients with stable CAD and recent elective PCI and help prioritize referral for cardiovascular rehabilitation in high-risk patients.
通过心肺运动测试（CPET）评估的功能能力（FC）是冠心病（CAD）患者的一种新的独立预后标志物。中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）是两种易于获得的全身炎症和心血管事件风险预测指标，可作为 FC 不良的经济有效的预测指标。本研究旨在评估 NLR 和 PLR 在预测 CAD 患者近期择期经皮冠状动脉介入治疗（PCI）后 FC 不良的价值。
我们的回顾性横断面研究纳入了 80 例 2020 年 1 月至 2021 年 6 月期间因稳定型 CAD 且近期择期行 PCI 而被转诊至心血管康复中心的患者。所有患者均接受了临床检查、踏车心肺运动试验、经胸超声心动图和标准血液分析。
根据氧摄取量占预计值的百分比（% VO2 max）将患者分为两组：FC 不良（≤70%，n = 35）和 FC 正常（>70%，n = 45）。两组在年龄、性别比、合并症存在情况、左心室射血分数和 NLR 方面无显著差异。FC 不良患者的 PLR 较高（169.8 ± 59.3 vs. 137.4 ± 35.9，p = 0.003）。PLR 截断值为 139 时，预测 FC 不良的敏感性为 74%，特异性为 60%。多变量分析后，PLR 仍然是 FC 不良的显著预测指标。
虽然 CPET 是评估心血管康复前 FC 的金标准，但它的应用仍然有限。PLR 是一种廉价且简单的测试，可预测稳定型 CAD 患者近期择期 PCI 后 FC 不良，并有助于在高危患者中优先转诊进行心血管康复。
