Correlation analysis of platelet –to–lymphocyte ratio and recent major adverse cardiac and cerebrovascular events in patients with severe heart failure

Huang Zong-yin

doi:10.3969/j.issn.1002-1949.2018.01.008

Abstract：Objective To investigate the correlation of platelet -to-lymphocyte ratio (PLR) and recent major adverse cardiac and cerebrovascular events ( MACCE ) in patients with severe heart failure.Methods From October 2014 to October 2016, a total of 170 cases of elderly patients with severe heart failure ( HF) in our hospital were included .According to the follow -up of 6 months after discharge whether occurring MACCE , they were divided into MACCE group ( n=60 ) and non-MACCE group ( n=110 ) .General clinical data and laboratory tests were compared between the two groups , and the relationship between PLR and MACCE was analyzed using Logistic regression equation analysis . Results Proportion of history of atrial fibrillation , SBP, TG, LDL-C, BNP, CRP of MACCE group were higher than those of non -MACCE group meanwhile LVEF of MACCE group was lower than that of non-MACCE group, the differences between the two groups were statistically significant (P<0.05);Platelet counts ( PLT) and PLR of the MACCE group on admission or at discharge were higher than those of non-MACCE group meanwhile lymphocyte count was lower than that of non -MACCE group, the differences between the two groups were statistically significant ( P <0.05 ); The total incidence of MACCE from A1 to A4, from B1 to B4, was increased, and the total incidence of the four groups was statistically different(χ2 =29.214, P<0 .001); Pearson correlation analysis showed that PLR level on admission or at discharge were positively correlated with BNP and CRP (P<0.05), while PLR was negatively correlation with LVEF (P<0.05).Logistic regression analysis also showed that PLR was recent independent risk factor for MACCE in elderly patients with severe HF ( On admission: OR =2.421, 95％CI:1.520～3.476, P<0.05;At discharge:OR =2.085, 95％CI:1.494～3.485, P<0.05).The ROC curve analysis showed that PLR level on admission predicted the area under the curve of MACCE (AUC) was 0.840, optimal diagnostic intercept value was 132.58, and the sensitivity and specificity were 89.8％and 62.8％respectively.PLR level at discharge predicted the AUC was 0.812, optimal diagnostic intercept value was 116.45, and the sensitivity and specificity were 84.6％ and 57.9％respectively.Conclusion High levels of PLR may be the risk factor of MACCE in elderly patients with severe HF , and has certain prediction value , and the predicted value on admission is slightly higher than that at discharged .Clinical attention should to be pained in closely monitoring PLR level, in order to evaluate the prognosis of patients with early .