血小板与淋巴细胞比值预测急性冠状动脉综合征经皮冠状动脉介入治疗后主要不良心血管事件的效能：一项荟萃分析
Platelet-To-Lymphocyte Ratio Efficiency in Predicting Major Adverse Cardiovascular Events After Percutaneous Coronary Intervention in Acute Coronary Syndromes: A Meta-Analysis.
作者信息
Wang He, Zulikaier Tuerxun, Yumaierjiang Balati, Lyu Saiqi, He Pengyi
机构信息
Clinical Medicine Department, Xinjiang Medical University, 830054 Urumqi, Xinjiang, China.
Heart Center, The Fifth Affiliated Hospital of Xinjiang Medical University, 830011 Urumqi, Xinjiang, China.
出版信息
Rev Cardiovasc Med. 2025 May 21;26(5):27942. doi: 10.31083/RCM27942. eCollection 2025 May.
BACKGROUND
The platelet-to-lymphocyte ratio (PLR) is applied as a potential first-line prognostic predictor for many cardiovascular diseases due to its simplicity and accessibility. This meta-analysis aimed to quantify the predictive power of PLR for major adverse cardiovascular events (MACEs) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI), explore its predictive efficacy in different populations, and identify other potential influencing factors.
METHODS
PubMed, Embase, Cochrane Library, and Web of Science databases were comprehensively searched for eligible studies until February 7, 2025, based on the inclusion and exclusion criteria. The Newcastle-Ottawa scale (NOS) was employed for quality assessment. Sensitivity, specificity, summary receiving operating characteristic (SROC) and area under the curve (AUC) were combined using Stata 15.1 and Meta-DiSc software. Meta-regression analyses, subgroup analyses, threshold effect analyses, sensitivity analyses, and publication bias tests were performed.
RESULTS
Nine studies (7174 patients) were enrolled. High PLR could predict MACEs in ACS patients undergoing PCI, with 0.68 sensitivity (95% CI, 0.60-0.76), 0.65 specificity (95% CI, 0.57-0.73), and 0.72 AUC (95% CI, 0.68-0.76). Subgroup analyses noted that PLR better predicted MACEs after PCI in ACS patients in the subgroup with a higher proportion of female patients and the subset aged >60 years. Meta-regression analyses unveiled that study type ( < 0.01) and PLR cutoff value ( < 0.01) might be sources of heterogeneity in the sensitivity analyses, while the mean age ( < 0.001) and sex ratio ( = 0.05) might be sources of heterogeneity in the specificity analyses.
CONCLUSIONS
High PLR levels have favorable values in predicting in-hospital and long-term MACEs after PCI in ACS patients. The PLR had greater sensitivity and an improved ability to identify risk in patients aged >60 years and the subgroup with a higher proportion of women and was also more sensitive to in-hospital MACEs.
THE PROSPERO REGISTRATION
No. CRD42024537586, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024537586.
背景
血小板与淋巴细胞比值（PLR）因其简便性和易获取性，被用作多种心血管疾病潜在的一线预后预测指标。本荟萃分析旨在量化PLR对接受经皮冠状动脉介入治疗（PCI）的急性冠状动脉综合征（ACS）患者主要不良心血管事件（MACE）的预测能力，探讨其在不同人群中的预测效果，并确定其他潜在影响因素。
方法
根据纳入和排除标准，全面检索PubMed、Embase、Cochrane图书馆和Web of Science数据库，检索截至2025年2月7日的符合条件的研究。采用纽卡斯尔-渥太华量表（NOS）进行质量评估。使用Stata 15.1和Meta-DiSc软件合并敏感性、特异性、汇总接受操作特征（SROC）和曲线下面积（AUC）。进行了Meta回归分析、亚组分析、阈值效应分析、敏感性分析和发表偏倚检验。
结果
纳入9项研究（7174例患者）。高PLR可预测接受PCI的ACS患者发生MACE，敏感性为0.68（95%CI，0.60-0.76），特异性为0.65（95%CI，0.57-0.73），AUC为0.72（95%CI，0.68-0.76）。亚组分析指出，在女性患者比例较高的亚组和年龄>60岁的亚组中，PLR能更好地预测ACS患者PCI术后的MACE。Meta回归分析表明，研究类型（<0.01）和PLR截断值（<0.01）可能是敏感性分析中异质性的来源，而平均年龄（<0.001）和性别比（=0.05）可能是特异性分析中异质性的来源。
结论
高PLR水平在预测ACS患者PCI术后院内及长期MACE方面具有良好价值。PLR在年龄>60岁的患者以及女性比例较高的亚组中具有更高的敏感性和更好的风险识别能力，对院内MACE也更敏感。
PROSPERO注册编号：CRD42024537586，https://www.crd.york.ac.uk/PROSPERO/view/CRD42024537586 。
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