The association of mean platelet volume to lymphocyte ratio and noreflow in patients with myocardial infarction undergoing primary percutaneous coronary intervention

Ahmad Separham,Amir Arsalan Akbari,Pooyan Dehghani

doi:10.34172/jrcm.2020.016

Abstract

Introduction: The acute coronary events are one of the most common problems which are accounted to higher mortality and morbidity rate around the world. The underlying mechanism is related to occlusion, and the best therapy is to reopen the affected vessels. Many factors can influence the outcomes of percutaneous coronary intervention (PCI). Methods: This cross-sectional study was conducted on 845 cases with acute myocardial infarction (AMI) undergoing PCI for evaluation of the "No-Reflow" phenomenon who were referred to Shahid Madani hospital in 2018. All demographic, laboratory and angiographic studies were evaluated. The obtained data were recorded and analyzed by SPSS 21. Results: Among 845 patients with STEMI, the incidence of angiographic no-reflow was 28% (n = 245). The older cases with co-morbid diseases and cardiac-related risk factors were considered as vulnerable to no-reflow after PCI. The other parameters were partially decisive factors for the prediction of no-reflow and mortality rate, such as higher MPV and MPV to lymphocyte ratio. Conclusion: The coronary artery involvement is a troublesome event because of the established heart risk factors, and sometimes treating it with PCI could be complicated due to no-reflow. The simple predictors (i.e., MPV to lymphocyte ratio) could help us reduce morbidity and mortality.

Highlights

The acute coronary events are one of the most common problems which are accounted to higher mortality and morbidity rate around the world
This cross-sectional study was conducted on 845 cases with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) for evaluation of the “No-Reflow” phenomenon who were referred to Shahid Madani hospital in 2018
It was more likely that no-reflow has occurred in women with a higher level of Cr, hypercholesterolemia, C-reactive protein (CRP), and platelet to lymphocyte ratio (PLR)

Summary

Introduction

The acute coronary events are one of the most common problems which are accounted to higher mortality and morbidity rate around the world. The older cases with co-morbid diseases and cardiac-related risk factors were considered as vulnerable to no-reflow after PCI. The acute coronary and cerebro-cardiac events as first cardiovascular manifestation have same pathophysiologic mechanisms (i.e., atherosclerosis and thrombosis).[1] The improvement of technology, introducing new and powerful anti-thrombotic treatments may result in increased complexity of percutaneous coronary interventions (PCIs), and higher intervention risk. The clinical and laboratory experiences show that “no-reflow” is associated with necrosis of cardiac muscles, which is known as a predictor of mortality.[6,7,8] Currently, the data of other studies and analysis of controlled clinical trials demonstrate that white blood cell-related indices (e.g., platelet/lymphocyte ratio and neutrophil/lymphocyte ratio) are associated with higher mortality rate, repeated MI, and severe outcomes after acute coronary syndrome (ACS). The ratio of mean platelet volume to lymphocyte (MPV/lymphocyte) is suggested as a thrombotic and inflammatory marker which has been mainly evaluated in cases with malignant

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