Abstract
BackgroundThe platelet-to-hemoglobin ratio (PHR) has emerged as a prognostic biomarker in coronary artery disease (CAD) patients after PCI but not clear in CAD complicated with congestive heart failure (CHF). Hence, we aimed to assess the association between PHR and long-term all-cause mortality among CAD patients with CHF.MethodsBased on the registry at Guangdong Provincial People’s Hospital in China, we analyzed data of 2599 hospitalized patients who underwent coronary angiography (CAG) and were diagnosed with CAD complicated by CHF from January 2007 to December 2018. Low PHR was defined as ˂ 1.69 (group 1) and high PHR as ≥ 1.69 (group 2). Prognosis analysis was performed using Kaplan–Meier method. To assess the association between PHR and long-term all-cause mortality, a Cox-regression model was fitted.ResultsDuring a median follow-up of 5.2 (3.1–7.8) years, a total of 985 (37.9%) patients died. On the Kaplan–Meier analysis, patients in high PHR group had a worse prognosis than those in low PHR group (log-rank, p = 0.0011). After adjustment for confounders, high PHR was correlated with an increased risk of long-term all-cause mortality in CAD patients complicated with CHF. (adjusted hazard ratio [aHR], 1.31; 95% confidence interval [CI], 1.13–1.52, p < 0.0001).ConclusionElevated PHR is correlated with an increased risk of long-term all-cause mortality in CAD patients with CHF. These results indicate that PHR may be a useful prognostic biomarker for this population. Meanwhile, it is necessary to take effective preventive measures to regulate both hemoglobin levels and platelet counts in this population.
Highlights
Coronary artery disease (CAD) is the leading cause of morbidity and mortality globally
We aimed to investigate the relationship between platelet-to-hemoglobin ratio (PHR) and long-term all-cause mortality of coronary artery disease (CAD) patients with congestive heart failure (CHF)
A total of 1857 (71.5%) patients underwent percutaneous coronary intervention (PCI) treatment, 1290 (49.7%) patients were diagnosed as Acute myocardial infarction (AMI), 1117 (43.0%) patients were identified as having Chronic kidney disease (CKD), 921 (35.5%) patients had diabetes mellitus (DM)
Summary
Coronary artery disease (CAD) is the leading cause of morbidity and mortality globally. CAD complicated by heart failure especially carries considerable morbidity and poor prognosis [1]. Those facts indicate that it is necessary to quest useful and simple indicators to evaluate the prognosis of CAD patients complicated with congestive heart failure (CHF) for effective and timely intervention strategies. High circulating platelet counts have been reported to be associated with poor outcomes in cardiovascular disease [4,5,6], the mechanism of which may be inflammatory response [7, 8] and platelet activation [9]. The platelet-to-hemoglobin ratio (PHR) has emerged as a prognostic biomarker in coronary artery disease (CAD) patients after PCI but not clear in CAD complicated with congestive heart failure (CHF).
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