Abstract
Introduction: Platelet large cell ratio (P-LCR) test is one of the test parameters that is routinely calculated in the hemogram test, and expressed as the ratio of platelets with platelet volume greater than 12 fL. Large platelets are relatively younger and contain more intracellular granules, meaning that platelets have more thrombogenic potential. In the literature investigating the relationship between the acute coronary syndrome and P-LCR levels, the use of aspirin in patients and its effects on platelet parameters were ignored. In our study, for the first time in the literature, the relationship between P-LCR levels and acute coronary syndromes were investigated by means of including the patients before they took aspirin which ensures that P-LCR test is not affected by aspirin. Method: Retrospectively, patients aged 18-70 years were screened and those whose hemogram tests were completed before aspirin usage were included. A total of 109 patients diagnosed with unstable angina (UA), non-ST elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI) were included and compared in the study. Results: The mean P-LCR values were 23.61% (95% CI: 21.97-25.25) in UA patients, 28.34% (95% CI: 24.86-31.83) in NSTEMI, and 25.71% (95% CI: 22.07-29.35) in STEMI patients. There was a statistically significant difference between the P-LCR values among the groups (p=0.022). Conclusion: The increase in P-LCR, free of aspirin effects, was found to be statistically significant in acute coronary syndromes.
Highlights
Platelet large cell ratio (P-LCR) test is one of the test parameters that is routinely calculated in the hemogram test, and expressed as the ratio of platelets with platelet volume greater than 12 fL
In our study, 109 patients aged 18-70 years who were diagnosed with acute coronary syndrome (ACS), having hemogram tests before aspirin usage were included
The mean age of unstable angina (UA) patients was 41.03 ± 12.49 years, non-ST elevation myocardial infarction (NSTEMI) patients were 54.42 ± 10.57 years, ST-elevation myocardial infarction (STEMI) patients were 54.30 ± 12.60 years and there was a significant difference between the groups (P < 0.001)
Summary
Platelet activation leads to an increase in platelet consumption in the area of atherosclerotic plaque rupture This leads to the release of large-sized platelets from the bone marrow during an acute coronary event.[3] Large platelets are relatively younger and contain more intracellular granules, meaning that platelets have more thrombogenic potential.[4] Hemogram is an easy and inexpensive test that can be performed in all health systems, including primary care centers. The predictivity of P-LCR test, which is known to play a role in atherogenesis and thrombosis pathogenesis, in the diagnosis of ACS in patients who were not affected by prior aspirin usage, was investigated for the first time in the literature
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