Mean platelet volume-to-lymphocyte ratio as a predictor of no-reflow phenomenon and in-hospital mortality following primary percutaneous coronary intervention in patients with STEMI

Abstract

Abstract Background ST-segment elevation myocardial infarction (STEMI) is the most severe form of acute coronary syndrome. Primary percutaneous coronary intervention (PCI) is currently the treatment of choice for STEMI. However, many factors can influence the outcomes of primary PCI. Inflammation and platelet activation play a vital role in the development of complications following primary PCI. Recently, the mean platelet volume-to-lymphocyte ratio (MPVLR) has emerged as a novel biomarker of worse outcomes linking inflammation and thrombosis. Purpose The aim of this study was to conduct a systematic review and meta-analysis to investigate the prognostic value of MPVLR as a predictor of no-reflow phenomenon and in-hospital mortality following primary PCI in patients with STEMI. Methods A systematic literature search was performed in the databases of PubMed, ScienceDirect, ProQuest, and Google Scholar. The primary outcomes were no-reflow phenomenon and in-hospital mortality following primary PCI for STEMI. The outcomes were compared between patients with high and low MPVLR at admission. The Newcastle-Ottawa Scale was used to assess the quality of the included studies. The Review Manager 5.3 was used to perform the meta-analysis. Results Four cohort studies involving 3038 patients with STEMI undergoing primary PCI were included in this meta-analysis. The pooled analysis showed that a high MPVLR at admission was associated with higher no-reflow phenomenon (odds ratio [OR] = 4.54, 95% confidence interval [CI]: 2.45–8.41, P<0.ehab724.13681, I2=86%) and higher in-hospital mortality (OR=2.69, 95% CI: 1.96–3.68, P<0.ehab724.13681, I2=0%) following primary PCI. Conclusions This systematic review and meta-analysis showed that a high MPVLR predicts no-reflow phenomenon and in-hospital mortality following primary PCI in patients with STEMI. Funding Acknowledgement Type of funding sources: None. MPVLR and no-reflow phenomenonMPVLR and in-hospital mortality