Abstract
It has been discovered that both inflammation and platelet aggregation could cause crucial effect on the occurrence and development of cardiovascular diseases. As a combination of platelet and lymphocyte, platelet-lymphocyte ratio (PLR) was proved to be correlated with the severity as well as prognosis of cardiovascular diseases. Exploring the relationship between PLR and in-hospital mortality in cardiac intensive care unit (CICU) patients was the purpose of this study. PLR was calculated by dividing platelet count by lymphocyte count. All patients were grouped by PLR quartiles and the primary outcome was in-hospital mortality. The independent effect of PLR was determined by binary logistic regression analysis. The curve in line with overall trend was drawn by local weighted regression (Lowess). Subgroup analysis was used to determine the relationship between PLR and in-hospital mortality in different subgroups. We included 5577 CICU patients. As PLR quartiles increased, in-hospital mortality increased significantly (Quartile 4 vs. Quartile 1: 13.9 vs. 8.3, P < 0.001). After adjusting for confounding variables, PLR was proved to be independently associated with increased risk of in-hospital mortality (Quartile 4 vs. Quartile 1: OR 95% CI 1.55, 1.08–2.21, P = 0.016, P for trend < 0.001). The Lowess curves showed a positive relationship between PLR and in-hospital mortality. The subgroup analysis revealed that patients with low Acute Physiology and Chronic Health Evaluation IV (APACHE IV) or with less comorbidities had higher risk of mortality for PLR. Further, PLR quartiles had positive relation with length of CICU stay (Quartile 4 vs. Quartile 1: 2.7, 1.6–5.2 vs. 2.1, 1.3–3.9, P < 0.001), and the length of hospital stay (Quartile 4 vs. Quartile 1: 7.9, 4.6–13.1 vs. 5.8, 3.3–9.8, P < 0.001). PLR was independently associated with in-hospital mortality in CICU patients.
Highlights
It has been discovered that both inflammation and platelet aggregation could cause crucial effect on the occurrence and development of cardiovascular diseases
Previous studies have demonstrated that increased peripheral blood platelet count caused the rise of adverse cardiovascular outcomes, in patients with acute myocardial infarction (AMI), higher platelet count was proved to be associated with mortality and reinfarction within the first year after primary percutaneous intervention (PCI)[7,8,9,10]
This is the first study to explore the role of platelet-lymphocyte ratio (PLR) in patients with severe cardiovascular disease, which will provide a clinical basis for the application of PLR in cardiac intensive care unit (CICU) patients
Summary
It has been discovered that both inflammation and platelet aggregation could cause crucial effect on the occurrence and development of cardiovascular diseases. Exploring the relationship between PLR and in-hospital mortality in cardiac intensive care unit (CICU) patients was the purpose of this study. PLR was independently associated with in-hospital mortality in CICU patients. Previous studies have demonstrated that increased peripheral blood platelet count caused the rise of adverse cardiovascular outcomes, in patients with acute myocardial infarction (AMI), higher platelet count was proved to be associated with mortality and reinfarction within the first year after primary percutaneous intervention (PCI)[7,8,9,10]. In the area of non-cardiovascular disease, PLR was proved to be an important inflammatory marker that predicted mortality in cancer population[16,17,18], critical limb ischemia in peripheral artery disease[19] and neonate early-onset sepsis[20]. Investigating the relationship between PLR and in-hospital mortality of patients in CICU was the target of this research
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