Mean Platelet Volume-to-lymphocyte Ratio Research Articles

Comparison Of The Relationship Between Inflammatory Markers And Saphenous Vein Graft Disease In Patients With Stable Angina Pectoris.

Aim: Coronary artery bypass graft surgery is one of the most commonly used strategies to revascularization of occlusive coronary atherosclerotic lesions. Atherosclerosis is known to be a chronic inflammatory process. Many inflammatory cells and mechanisms are active in this process. Markers such as mean platelet volume-to-lymphocyte ratio (MPVLR) and C-reactive protein-to-albumin (CAR) which may be associated with the severity of inflammation. In this study, it was aimed to determine the relationship between these parameters and saphenous vein graft (SVG) diseases. Methods: In this retrospective study, 314 patients SVG disease with stable angina pectoris were included. Patients were divided into two groups according to the severity of SVG disease. We compared 159 patients who had severe stenosis in SVG and 156 patients who did not,in terms of CAR, NLR, PLR, MPVLR. Results: Patients who ≥50% stenosis in SVG had significantly higher CAR, MPVLR, NLR, and PLR (respectively 9.1 (4.2-16.8) p<0.001, 4.5)0.68) p<0.001, 2.4 (0.69) p=0.002, 153 )6) p=0.048). In line with these data, CAR and MPVLR values were also higher in the group with ≥50% stenosis in SVG, which was highly statistically significant (respectively 3.2 (0.9-4.4) vs 9.1 (4.2-16.8); p<0.001 and 3.64)0.43) vs 4.53)0.68); p<0.001). Conclusion: C-reactive protein-to-albumin and MPVLR can be a useful and easily accessible markers to predict severity SVG stenosis.

Mean platelet volume-to-lymphocyte ratio predicts poor functional outcome of acute ischemic stroke patients

Background & Objective: The mean platelet volume-to-lymphocyte ratio (MPVLR) is a novel and easily available marker of poor short-term prognosis in myocardial infarction patients. The present study was to investigate the association between MPVLR and clinical outcome of patients with acute ischemic stroke. Methods: A total of 494 acute ischemic stroke patients were included in this study and received 3-months follow-up. Blood samples for MPVLR were obtained at admission and at 7 days after acute ischemic stroke. Poor functional outcome was defined as a modified Rankin Scale (mRS) score of 3-6 at 3 months after stroke. Results: Compared with good prognosis group, MPVLR level at admission and at 7 days in poor prognosis group was significantly higher, the difference between these two groups was statistically significant (P < 0.001). In multivariate logistic regression analysis, both MPVLR as a continuous (OR 1.13; 95%CI, 1.064-1.190, P=0.001) and categorical variable (OR 3.05; 95%CI, 1.85-5.05, P<0.001) were independently associated with poor outcome at 3 months. ROC analysis revealed the predictive value of MPVLR was better than that of platelet-to lymphocyte ratio (PLR). The nomogram was used for predicting 3-months unfavourable outcome after an acute ischemic stroke. Conclusions: MPVLR at admission and at 7 days after stroke were found to be independently associated with poor functional outcome. MPVLR may serve as an activity marker for poor prognosis in patients with acute ischemic stroke.

Mean Platelet Volume to Lymphocyte Ratio: A New Biomarker Predicting Response in Patients with Solid Tumors Treated with Nivolumab.

Although immune checkpoint inhibitors (ICIs) are widely used in cancer treatment, identifying factors that predict treatment response remains a challenge in clinical practice. There is a need for biomarkers to identify patients who may not benefit from these treatments. It is crucial to identify a simple and cost-effective biomarker that can be easily incorporated into clinical practice. This study aims to investigate the mean platelet volume to lymphocyte ratio (MPVLR), as measured by a hemogram test, and median overall survival (mOS) in patients with cancer treated with nivolumab. A total of 131 adult patients with metastatic cancer, including malignant melanoma (MM), renal cell carcinoma (RCC), non-small cell lung cancer (NSCLC), and head and neck cancer (HNC), were included in this study. Baseline demographics, ECOG (Eastern Cooperative Oncology Group) performance status, tumor type, and blood count parameters were recorded. Univariate and multivariate analyses were conducted to evaluate potential risk factors. The median age of the patients was 59.87 ± 11.97 years, and the median follow-up period was 20.20 months (IQR, 12.80-27.60). RCC (43.5%) and MM (25.9%) were the most common diagnoses. Patients with ECOG scores of 0-1 had a longer mOS than those with scores of 2-3 (mOS: 20.60 months [95% CI, 14.94-25.29] vs. 5.24 months [95% CI, 0-16.42], p < 0.001). Additionally, patients with lactate dehydrogenase (LDH) levels within the normal range had a longer mOS than those with high LDH levels (mOS: 24.54 months [95% CI, 14.13-34.96] vs. 13.10 months [95% CI, 4.49-21.72], p = 0.038). Patients with low MPVLR also had a longer mOS than those with high MPVLR (mOS: 33.70 months [95% CI, 25.99-41.42] vs. 11.07 months [95% CI, 6.89-15.24], p < 0.001). In the multivariate Cox regression analysis, high MPVLR, ECOG score of 2-3, and high LDH level were associated with shorter mOS (p < 0.001, p = 0.001, and p = 0.046, respectively). This study demonstrates that MPVLR could serve as a novel biomarker for predicting response to nivolumab treatment. Incorporating MPVLR into clinical practice may aid in identifying patients who are less likely to benefit from the treatment.

Effect of ticagrelor and clopidogrel dual antiplatelet therapy on MPVLR, MAADP, and AA inhibition rate in acute coronary syndrome patients after percutaneous coronary intervention.

To explore the effects of ticagrelor and clopidogrel dual antiplatelet therapy on the mean platelet volume-to-lymphocyte ratio (MPVLR), maximum amplitude of adenosine diphosphate-induced platelet-fibrin clots (MAADP), and arachidonic acid (AA) inhibition rates in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). A total of 120 patients with ACS undergoing elective PCI in our hospital between March 2020 and November 2021 were recruited. Patients were divided into 2 groups using the random number table method, with 60 patients in each group. The control group received clopidogrel + aspirin dual antiplatelet therapy, while the study group received ticagrelor + aspirin dual antiplatelet therapy. MPVLR, MAADP, and AA inhibition rates were compared between the 2 groups. Platelet activation indices, platelet micro PNA-223, and platelet gelsolin levels were measured before and 4 weeks after PCI. Changes in cardiac function indices, bleeding rates, and major adverse cardiovascular events (MACE) were compared between groups. The MAADP score of the study group was lower than that of the control group 3 days after surgery (P < .05). Compared with before surgery, CD62p, CD63, miR-223, PAC-1, platelet membrane glycoprotein IIb/IIIa complex, and gelsolin levels markedly decreased in both groups 4 weeks after surgery (P < .05). The platelet activation index and platelet miR-223 and gelsolin levels were significantly lower in the study group than in the control group 4 weeks after surgery (P < .05). The overall platelet inhibition effect was significantly better in the study group than in the control group (P < .05). Compared with before surgery, the left ventricular ejection fraction and stroke volume were significantly increased, and the left ventricular end-diastolic volume and left ventricular end-diastolic diameter significantly decreased in both groups 4 weeks after surgery (P < .05). No significant differences were found between the 2 groups in terms of the incidence of bleeding events or MACE (P > .05). Ticagrelor is more effective than clopidogrel for platelet inhibition after PCI in patients with ACS and is worthy of clinical recommendation.

MEAN PLATELET VOLUME TO LYMPHOCYTE RATIO AS AN EARLY INDICATOR OF DIABETIC NEPHROPATHY

Objective: To predict the risk of diabetic nephropathy in patients with type 2 Diabetes Mellitus using Mean platelet volume to lymphocyte ratio (MPVLR) and comparison with diabetics without nephropathy. Material and Methods: This Cross-sectional study was conducted at Chughtai Institute of Pathology, in Lahore, Pakistan from July to December 2021. 100 Patients with type 2 Diabetes mellitus were included. Two groups were made based on the urinary microalbumin/creatinine ratio: diabetic nephropathy and non-nephropathy group. MPVLR derived by dividing MPV to total lymphocyte count. Results: There were a total of 100 subjects. Mean age of patients of group A was 45.99±13.42 years while mean age of patients of group B was 41.87±14.65 years and p-value 0.105. 75.2% patients of group A were female while 82.1% patients of group B were female (p-value 0.185). The MPVLR of group A was 45.51±8.32 while of group B was 70.33±13.40 (p-value 0.001). The best cut-off value for MPVLR when compared with those of group B indicated a P value that is evident and in relation to that given in literature proving the hypothesis. Conclusion: The MPVLR is an easily calculated and efficient index and higher values indicate inflammation. It may be considered an independent and reliable predictor of diabetic nephropathy. We suggest, it can be a useful complement to standard tests in labeling diabetic nephropathy. Key Words: HBA1C, Diabetic nephropathy, Platelet indices, Mean platelet volume to lymphocyte ratio

Role of combined use of mean platelet volume-to-lymphocyte ratio and monocyte to high-density lipoprotein cholesterol ratio in predicting patients with acute myocardial infarction

BackgroundAtherosclerosis and thrombosis play important roles in the pathophysiology of acute coronary syndrome, with platelet activation and inflammation as the key and initiative factors. Recently mean platelet volume-to-lymphocyte ratio (MPVLR) and monocyte to high-density lipoprotein cholesterol ratio (MHR) have emerged as new prognostic indicators of cardiovascular diseases. However, the predicting effect of the combination of MPVLR and MHR in myocardial infarction has not been reported.ObjectiveThe aim of this study was to investigate the usefulness of combination of MPVLR and MHR in predicting patients with AMI.Methods375 patients who had chest pain or stuffiness were retrospectively enrolled in this study. According to the results of coronary angiography and cardiac troponin, patients were divided into AMI group (n = 284) and control group (n = 91). MPVLR, MHR, Gensini score and Grace score were calculated.ResultsMPVLR and MHR were significantly higher in AMI group than that in control group (6.47 (4.70–9.58) VS 4.88 (3.82–6.44), 13.56 (8.44–19.01) VS 9.14 (7.00–10.86), P < 0.001, respectively). Meanwhile, both were positively correlated with Gensini score and Grace score. Patients with a high level of MPVLR or MHR had an increased risk for AMI (odds ratio (OR) = 1.2, 95% confidence interval (CI) 1.1–1.4, OR = 1.2, 95% CI 1.2–1.3). Combination of MPVLR and MHR identified a greater ROC area than its individual parameters (P < 0.001).ConclusionBoth MPVLR and MHR are independent predictors of AMI. Combination of MPVLR and MHR had higher predicting value in AMI, and thus appears to be a new risk factor and biomarker in the evaluation of risk and severity of atherosclerosis in AMI.

Mean Platelet Volume-to-Lymphocyte Ratio Is a Biomarker of 1-Year Mortality in Patients With Diabetic Foot Infections.

We aimed to evaluate the value of 2 peripheral blood cell ratios, the mean platelet volume-to-lymphocyte ratio (MPVLR) and the neutrophil-to-lymphocyte ratio (NLR) as prognostic biomarkers of mortality in patients with diabetic foot infections (DFIs). We conducted a prospective observational study consisting of a cohort of 200 patients with moderate to severe DFIs consecutively recruited from our Diabetic Foot Unit, Hospital San Juan de Dios, San José de Costa Rica, Costa Rica from October 15, 2020, to December 15, 2021. We studied the variables associated with one-year all-cause mortality using a multivariate backward Cox's regression model. Nonparametric Spearman Rho was used to study the linear correlation between NLR and MPVLR and other inflammatory markers. The variables associated with all-cause mortality were retinopathy (hazard ratio [HR]: 2.55, 95% confidence interval [CI]: 1.22-5.33, P = .01), estimated glomerular filtration rate (HR: 0.979, 95% CI: 0.969-0.990, P < .001), HbA1c (HR: 0.825, 95% CI: 0.702-0.969, P = .01), and MPVLR (HR: 1.093, 95% CI: 1.020-1.172, P = .01). NLR showed a strong correlation with white blood cell count (r = 0.60 [<0.001]) and c-reactive protein (r = 0.63 [<0.001]), and a weak correlation with erythrocyte sedimentation rate (r = 0.33 [<0.001]), though it was not associated with mortality. In conclusion, apart from other risk factors of mortality, we have for the first time demonstrated that the increasing value of MPVLR is a factor associated with one-year mortality in patients with DFIs.

The different predictive value of mean platelet volume-to-lymphocyte ratio for postoperative recurrence between non-muscular invasive bladder cancer patients treated with intravesical chemotherapy and intravesical chemohyperthermia.

The inflammatory response plays a potential role in postoperative recurrence in patients with non-muscular invasive bladder cancer (NMIBC). We aimed to investigate whether platelet-to-lymphocyte ratio (PLR), mean platelet volume to lymphocyte ratio (MPVLR), and the systemic immune-inflammatory index (SII) have prognostic values in NMIBC treated with conventional intravesical chemotherapy or intravesical Chemohyperthermia (CHT) and the differences between them. A retrospective cohort study was conducted on 222 patients with NMIBC treated with Intravesical Chemotherapy or Intravesical CHT between January 2016 and December 2020. Within a week before surgery, PLR, MPVLR, and SII were determined based on routine blood settling. The optimal cutoff value of each index was determined using the receiver operating characteristic curve, and various groups were categorized accordingly. The factors influencing the prognosis of NMIBC patients receiving various treatments were investigated using the Kaplan- Meier survival curve and the Cox regression model. 69 cases (46.3%) in the gemcitabine (GEM) group had tumor recurrence and 19 (12.8%) of them progressed to muscle-invasive bladder cancer (MIBC) or got metastasis, while 19 cases (26.0%) in the CHT group recurred and 2 (2.7%) progressed. Elevated PLR, MPVLR, and SII were associated with higher recurrence rates in the GEM group. Meanwhile, PLR and MPVLR were the independent risk factors. While in the CHT group, high PLR and SII were related to postoperative recurrence and none of them were independent risk factors. The preoperative clinical inflammatory indexes PLR, SII, and MPVLR have certain predictive value for the postoperative recurrence-free survival (RFS) in NMIBC patients treated with intravesical chemotherapy while PLR and SII can predict the prognosis of NMIBC patients treated with intravesical CHT, which indicates that intravesical CHT may stop tumor recurrence by influencing the effect of mean platelet volume on tumor growth through some unknown mechanisms.

A comparison of on-admission blood cell count-derived parameters on the development of contrast-induced nephropathy in acute coronary syndromes

Contrast-induced nephropathy (CIN) is a clinical entity closely associated with cardiac mortality and morbidity. We aimed to investigate the relationship between CIN after acute coronary syndrome and other bio-inflammatory parameters (Neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio) as well as biomarkers such as AST/ALT, SIRI (Systemic Immnun Response Index), AISI (Aggregate Index of Systemic Inflammation), APRI (AST to platelet ratio index), SII (Systemic Immun Inflammation Index) NLR (Neutrophil to lymphocyte ratio), N/LPR (Neutrophil/ (lymphocyte x platelet), PLR (Platelet to lymphocyte ratio), MLR (Monocyte to lymphocyte ratio) and MPVLR (Mean platelet volume to lymphocyte ratio). In this retrospective cross-sectional study, we included 228 patients older than 18 years of age and underwent coronary angiography for acute coronary syndrome between January 2021 and May 2022. We applied the logistic regression analyzes to evaluate the relationship between patients' demographic, clinical characteristics, laboratory parameters, and contrast-induced nephropathy, and to evaluate the predictive power of the AST/ALT, AISI, SIRI, SII, NLR, PLR, MLR, N/LP ratio, MPVLR and other inflammatory based parameters on this primary endpoint. In the univariate analyses, prior history of coronary artery bypass, acute coronary syndrome type, prior ACEi/ARB usage, white blood cell count, hospitalization stay length, contrast amount, MLR, PLR, white blood cell to platelet ratio (WBCPR) were significantly associated with CIN. [p:0.039, p:0.017, p:0.025, p:0.044, p&lt;0.001, p:0.003, p: 0.045, p: 0.044, p:0.044, respectively]. However, multivariable logistic regression analysis showed that WBCPR [OR 0.00 (95% CI 0.00- 0.01) p:0.005] and MLR [OR 13.522 (95% CI 2.15-84.72) p:0.005] might be statistically a significant independent predictor of CIN beside contrast amount [OR 1.92 (95% CI 01.23-3.02) p:0.004]. The WBCPR can be a new valuable independent predictor of CIN. Also, MLR and contrast amount may be a good independent predictor of CIN in acute coronary syndrome.

A new marker of short-term mortality and poor outcome in patients with acute ischemic stroke: Mean platelet volume-to-lymphocyte ratio.

Background:The mean platelet volume-to-lymphocyte ratio (MPVLR), as a novel marker of thrombosis and inflammation, has been demonstrated to be closely linked to poor cardiovascular disease prognosis. However, the correlation between MPVLR and acute ischemic stroke (AIS) remains unclear. This study, therefore, aimed to clarify the relationship between MPVLR and the short-term prognosis of AIS.Methods:A total of 315 patients with first-time AIS diagnoses were recruited and divided into 3 groups based on the tri-sectional quantiles for MPVLR on admission: group 1 (N = 105) with a MPVLR ≤ 4.93, group 2 (N = 105) with a MPVLR of 4.94 to 7.21, and group 3 (N = 105) with a MPVLR ≥ 7.22. All patients were followed-up for 3 months, and death within 3 months was defined as the endpoint. Baseline characteristics, stroke severity, and functional outcomes were evaluated.Results:The Spearman’s correlation coefficient test showed that MPVLR was significantly positively correlated with the National Institutes of Health Stroke Scale score (R = 0.517, P < .001). Multivariate analysis revealed that MPVLR was an independent predictor of both short-term mortality (adjusted odds ratio [OR] 1.435, P < .001) and poor outcome (adjusted OR 1.589, P < .001). The receiver operating characteristic (ROC) curve analysis showed that the best cutoff value of MPVLR for short-term mortality and poor outcome were 6.69 (sensitivity: 86.4%, specificity: 68.6%) and 6.38 (sensitivity: 78.8%, specificity: 72.3%), respectively.Conclusions:MPVLR on admission was positively associated with stroke severity. An elevated MPVLR is an independent predictor of short-term mortality and poor outcome after AIS.

The predictive role of mean platelet volume to lymphocyte ratio and neutrophil-to-lymphocyte ratio for cardiovascular events in adult patients with acute heart failure

Abstract Introduction The inflammatory response plays a potential role for the pathogenesis and adverse outcomes of heart failure (HF). Purpose We aimed to explore the predictive role of neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume to lymphocyte ratio (MPVLR) on cardiovascular events (CVEs) in patients hospitalized with acute HF. Methods A retrospective cohort study was conducted in 321 patients with HF between January 2017 and December 2019. The association between their NLR, MPVLR and combined NLR and MPVLR, and CVEs, HF re-hospitalization, in-hospital death, and a composite outcome were explored by survival analysis using a Cox proportional hazard model. They were separately investigated and compared with the area under the receiver operating characteristics curve (AUC). Results Up to the end of the 3-year follow-up, 96 (29.9%) had CVEs, 106 (33.0%) died, 62 (19.3%) were re-hospitalized with HF, and 21 (6.5%) died during admission. The NLR and MPVLR were significantly associated with CVEs (adjusted HR for NLR ≥3.29, 3.11; 95% CI, 1.98–4.89, MPVLR ≥8.57, 2.86; 95% CI, 1.87–4.39), HF readmission (adjusted HR for NLR ≥3.58, 2.70; 95% CI, 1.58–4.61, MPVLR ≥6.43, 2.84; 95% CI,1.59–5.07), in-hospital mortality (adjusted HR for NLR ≥3.29, 9.54; 95% CI, 2.19–41.40, MPVLR ≥8.57, 7.87; 95% CI, 2.56–24.19), and composite outcome (adjusted HR for NLR ≥3.32, 4.76; 95% CI, 3.29–6.89, MPVLR ≥7.07, 3.64; 95% CI, 2.58–5.15). The AUC of NLR and MPVLR for CVEs were 0.67 (95% CI, 0.61–0.72), and 0.63 (95% CI, 0.58–0.69). Combined NLR and MPVLR increased the AUC to 0.77 (95% CI, 0.72–0.83) with statistical significance. Conclusion The elevated NLR and MPVLR on admission in patients with acute HF were independently associated with worse CVEs, HF re-hospitalization, in-hospital death, and composite outcomes. These economical biomarkers should be considered in the management and follow-up care of patients with acute HF. Funding Acknowledgement Type of funding sources: None.

The relationship between platelet indices and residual SYNTAX score in patients with ST-segment elevation myocardial infarction

Objectives: Our aim is to investigate the relationship between thrombocyte indices, which have previously been proven to be associated with many cardiovascular diseases and adverse events, and residual SYNTAX (SYNergy between percutaneous coronary interventionwith TAXus and cardiac surgery) score (rSS) in patients with ST-segment elevation myocardial infarction (STEMI). Methods: Our study included 534 patients who underwent primary percutaneous coronary intervention (PCI) for STEMI between January 2018 and June 2021. In our study, only patients who underwent infarct-related coronary artery revascularization in the index procedure were evaluated. First of all, patients were compared as two groups as low rSS (rSS ≤ 8) and high rSS (rSS &amp;gt; 8). Our definition of platelet indices includes mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (Pct), MPV to platelet ratio (MPVPR), platelet to lymphocyte ratio (PLR), and MPV to lymphocyte ratio (MPVLR). Results: The mean age of the study patients was 56.4 ± 10.3 years and 78.8% were male. The high rSS group had higher C-reactive protein, lower lymphocyte count, and significantly higher platelet indices other than PLR and MPV. Among the platelet indices, MPVLR was found to have the best correlation with rSS (r: 0.398, p &amp;lt; 0.001). MPVLR (AUC: 0.820, 95% CI: 0.701-0.899) was determined as the best diagnostic power index with 5.08 cut-off value in predicting high rSS with 88% sensitivity and 76% specificity (Youden index: 0.64). Age, right coronary artery involvement as culprit lesion, ejection fraction, diabetes mellitus and MPVLR (OR: 5.966 [2.489-8.413], p &amp;lt; 0.001) and PDW were identified as independent risk factors for predicting high rSS. Conclusions: In conclusion, increased MPVLR is associated with high rSS in STEMI patients. There is a significant positive correlation between MPVLR and rSS. MPVLR is an independent predictor of high rSS.

Mean platelet volume to lymphocyte ratio and platelet distribution width to lymphocyte ratio in Iraqi patients diagnosed with systemic lupus erythematosus.

IntroductionThe mean platelet volume to lymphocyte ratio (MPVLR) and platelet distribution width to lymphocyte ratio (PDWLR) have the potential to serve as markers of inflammation which may indicate disease activity. The mean platelet volume to lymphocyte ratio and PDWLR were assessed in patients with systemic lupus erythematosus (SLE) in this study.Material and methodsSixty-two patients with systemic lupus erythematosus and 79 controls who were age and gender matched were included. Their sociodemographic information, as well as disease activity scores based on the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), disease duration, current medications, lymphocytes, platelets, platelet distribution width (PDW), and mean platelet volume (MPV), anti-nuclear antibody (ANA), anti-double stranded deoxyribonucleic acid (anti-dsDNA), and complement components (C3, C4) were recorded. The correlations of MPVLR and PDWLR with disease activity and some laboratory parameters were analyzed.ResultsLupus patients had significantly higher median (interquartile range) values for MPVLR and PDWLR than controls (5.69 [1.16–23.67] vs. 4.40 [2.78–11.93], p = 0.009) and 10.51 (2.87–79.37) vs. 5.21 (2.88–14.66), p < 0.001] respectively. According to the ROC curve, > 7.53 was the best PDWLR cut-off value for predicting SLE with a sensitivity of 71%, a specificity of 87% and an accuracy of 82.6%, whereas the optimum MPVLR cut-off value was > 6.46 with a sensitivity of 45.2%, a specificity of 88.9% and an accuracy of 76.8%. In addition, MPVLR had a significant positive correlation with SLEDAI (r = 0.34, p = 0.008). However, there was no significant correlation between PDWLR and SLEDAI (r = 0.23, p = 0.067). Furthermore, PDWLR had a significant positive correlation with PDW (r = 0.482, p < 0.001), while MPVLR had a significant negative correlation with C3 level (r = –0.260, p = 0.042). Both PDWLR and MPVLR were positively correlated with nephritis (r = 0.388, p = 0.002; r = 0.246, p = 0.038, respectively).ConclusionsThe platelet distribution width to lymphocyte ratio can be considered as an assisting biomarker in the diagnosis of SLE with the other clinical and serological parameters. The mean platelet volume to lymphocyte ratio may be used in the evaluation of disease activity in SLE patients.

Is There a Role for Laboratory Parameters in Predicting Coronary Artery Involvement in Kawasaki Disease?

Kawasaki disease (KD) may cause cardiac and coronary complications. Since definite markers to accurately predict coronary involvement is not present, we aimed to analyze the role of hematological indices [neutrophil-to lymphocyte ratio (NLR), platelet-to lymphocyte ratio (PLR), lymphocyte-to monocyte ratio (LMR), and mean platelet volume (MPV)-to lymphocyte ratio (MPVLR)], prognostic nutritional index (PNI) and systemic immune-inflammation index (SII) in predicting coronary involvement of KD. Patients The medical records of 134 KD patients admitted between January 2008 and December 2019 were investigated. Also, 268 age-matched healthy controls (HCs) were included in the study. KD patients were divided into two groups: KD with coronary artery lesions (KD-CALs) and KD without CALs. Logistic regression analysis was performed to determine parameters that may predict coronary involvement in children with KD. Among KD patients, 39 (29.1%) had CALs. When compared with HCs, the median levels of WBC, neutrophils, monocytes, eosinophils, platelets, MPV and, the values of NLR, PLR, MPVLR, SII were significantly higher; whereas lymphocyte count, PNI, platelet distribution width (PDW), LMR were markedly lower in the KD group (p˂0.001 for all, except for p=0.010 for eosinophil count). The CALs group's SII, PLR, and PNI values were significantly lower than those without (p=0.030, p=0.032, and p ˂0.001; respectively). Multivariable regression analysis revealed that PNI, SII, and gender (male) were associated with CALs in KD. Our analysis revealed that male sex, lower PNI, and lower SII levels were independently associated with CALs in children with KD.

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 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&amp;lt;0.ehab724.13681, I2=86%) and higher in-hospital mortality (OR=2.69, 95% CI: 1.96–3.68, P&amp;lt;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

The Predictive role of Neutrophil-to-Lymphocyte Ratio (NLR) and Mean Platelet Volume-to-Lymphocyte Ratio (MPVLR) for Cardiovascular Events in Adult Patients with Acute Heart Failure.

Introduction The inflammatory response plays a potential role for the pathogenesis and adverse outcomes of heart failure (HF). We aimed to explore the predictive role of baseline neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume-to-lymphocyte ratio (MPVLR) on cardiovascular events (CVEs) in patients hospitalized with acute HF. Materials and Methods A retrospective cohort study was conducted in 321 patients with HF between January 2017 and December 2019. The association between their NLR, MPVLR, and combined NLR and MPVLR and CVEs, rehospitalization for HF, in-hospital death, and a composite outcome was explored by survival analysis using a Cox proportional hazard model. They were separately investigated and compared with the area under the receiver operating characteristics curve (AUC). Results Up to the end of the 3-year follow-up, 96 (29.9%) had CVEs, 106 (33.0%) died, 62 (19.3%) were rehospitalized with HF, and 21 (6.5%) died during admission. The NLR and MPVLR were significantly associated with CVEs (adjusted HR for NLR ≥ 3.29, 3.11; 95% CI, 1.98-4.89; MPVLR ≥ 8.57, 2.86; 95% CI, 1.87-4.39), readmissions for HF (adjusted HR for NLR ≥ 3.58, 2.70; 95% CI, 1.58-4.61; MPVLR ≥ 6.43, 2.84; 95% CI,1.59-5.07), in-hospital mortality (adjusted HR for NLR ≥ 3.29, 9.54; 95% CI, 2.19-41.40; MPVLR ≥ 8.57, 7.87; 95% CI, 2.56-24.19), and composite outcome (adjusted HR for NLR ≥ 3.32, 4.76; 95% CI, 3.29-6.89; MPVLR ≥ 7.07, 3.64; 95% CI, 2.58-5.15). The AUC of NLR and MPVLR for CVEs were 0.67 (95% CI, 0.61-0.72) and 0.63 (95% CI, 0.58-0.69). Combined NLR and MPVLR increased the AUC to 0.77 (95% CI, 0.72-0.83) with statistical significance. Conclusion The elevated NLR and MPVLR on admission in patients with acute HF were independently associated with worse CVEs, rehospitalization for HF, in-hospital death, and composite outcomes. These economical biomarkers should be considered in the management and follow-up care of patients with acute HF.

"Prognostic Significance of Mean Platelet Volume to Lymphocyte Ratio in Patients with Metastatic Colon Cancer"

The tumor microenvironment has become a very important in cancer progression. Immune cells in peripheral blood are essential elements of this environment. The prognostic significance of Mean Platelet Volume to Lymphocyte Ratio (MPVLR) in patients with metastatic colon cancer is unknown. Our aim is to investigate the prognostic significance of MPVLR

Peripheral Blood Cell Ratios as Prognostic Predictors of Mortality in Patients with Hepatitis B Virus-Related Decompensated Cirrhosis.

We sought to determine the correlations between peripheral blood cell ratios (neutrophil-to-lymphocyte ratio (NLR), mean platelet volume-to-lymphocyte ratio (MPVLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-neutrophil ratio (PNR), and platelet-to-white blood cell ratio (PWR)) and short-term prognosis in patients with hepatitis B virus (HBV)-associated decompensated cirrhosis (HBV-DeCi). A total of 144 HBV-DeCi patients were enrolled. Demographic characteristics and laboratory data for the patients were acquired from their medical records. Multivariate regression analysis was applied to determine risk factors for unfavorable outcomes. The predictive performance of different ratios was examined by receiver operating characteristic curve analysis. Liver function was assessed by the Model for End-Stage Liver Disease (MELD) score. Twenty-one HBV-DeCi patients (14.6%) had died at 30 days. Survival was associated with lower NLR, MLR, MPVLR, and MELD score and higher PWR and PNR than non-survival. Multivariate analyses identified NLR and MELD score as independent prognostic predictors. The ability of NLR to predict mortality was higher than that of MLR, PNR, MPVLR, and PWR, but slightly lower than that of MELD score. The present results suggest that peripheral blood cell ratios can be useful for predicting mortality in HBV-DeCi patients. These ratios should be considered together with other measures for evaluation of prognosis in HBV-DeCi patients and are conducive to clinical practice.

Analysis of factors for disease progression in 61 patients with COVID-19 in Xiaogan, Hubei, China.

The aim of this study was to retrospectively analyze clinical characteristics and laboratory results of the novel coronavirus pneumonia (COVID-19) patients so as to identify factors related to disease progression. Sixty-one patients with COVID-19 were divided into two groups: an improvement/stabilization group (n = 53) and a progression group (n = 8). Clinical data were collected to analyze and compare the differences between the two groups. Of the sixty-one patients, thirty-one were male (50.8%), and thirty were female (49.2%), with a median age of 53 years. On admission, significant differences were observed between the two groups with respect to the levels of Creatine Kinase (CK), lymphocytes, D-dimer and creatinine, and prothrombin time (PT). Univariate logistic regression analysis showed that Platelet-to-lymphocyte ratio (PLR), lymphocytes, Mean platelet volume to lymphocyte ratio (MPVLR), CK, White Blood count to mean platelet volume ratio (WMR), Lymphocyte-to-monocyte ratio (LMR), and serum creatinine were important factors for disease progression. Multivariate logistic regression analysis showed that PLR was an independent factor for disease progression in COVID-19 patients. The receiver operating characteristic (ROC) curve revealed that the best predictor of disease progression was CK. Dynamic changes in the laboratory indicators of patients were tracked, and significant differences were found in the variation trends of white blood cell count, neutrophil count, and WMR, which gradually increased in the progression group, but gradually decreased in the improvement/stabilization group. Risk factors for disease progression included PLR, lymphocytes, MPVLR, CK, WMR, LMR, and creatinine, among which, PLR is an independent risk factor for disease progression in COVID-19 patients.

Retrospective Study of Clinical Features of COVID-19 in Inpatients and Their Association with Disease Severity.

BackgroundThe aim of this study was to analyze the clinical features and laboratory indices of patients with coronavirus disease (COVID-19) and explore their association with the severity of the disease.Material/MethodsA total of 61 patients with COVID-19 were divided into groups with common symptoms and with severe diseases, and clinical data were collected to analyze and compare the differences between them.ResultsIn patients with severe COVID-19, compared with the common group, lymphocyte count and albumin levels were lower, and aspartate aminotransferase (AST), blood urea, blood creatinine, lactate dehydrogenase (LDH), and C-reactive protein (CRP) levels, and prothrombin time (PT) were elevated (all P<0.05). The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume-to-lymphocyte ratio (MPVLR), and C-reactive protein-to-albumin ratio (CAR) were significantly elevated in the severe group compared with the group with common symptoms; however, the lymphocyte-to-monocyte ratio (LMR) was significantly reduced (P<0.05). Univariate logistic regression showed that lower lymphocyte count, prolonged PT, elevated CRP and LDH levels, and elevated NLR, PLR, MPVLR, and CAR were risk factors for COVID-19 severity (P<0.05). Multivariate logistic regression showed that elevated CRP levels (odds ratio [OR], 0.028; 95% confidence interval [CI]: 0.002–0.526; P=0.017), prolonged PT (OR, 0.014; 95% CI: 0.001–0.341; P=0.09), and an MPVLR >8.9 (OR, 0.026; 95% CI: 0.002–0.349; P=0.006) were independent risk factors for COVID-19 severity.ConclusionsElevated CRP and prolonged PT, and an MPVLR >8.9 were independent risk factors for COVID-19 severity.