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PLR AS A PROGNOSTIC INDICATOR TO ESTIMATE THE RISK OF IN-HOSPITAL MORTALITY AND MAJOR ADVERSE CARDIAC EVENTS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
Sami Mohammad Armiaa Mufti*, Housam Balleh, Firas Hussein
Background : Platelet to lymphocyte ratio (PLR) is a new prognostic value for both inflammatory and thrombotic process which have a vital role in the pathophysiology of myocardial infarction and major adverse myocardial outcomes. Objective: To assess the prognostic value of PLR as an indicator of in-hospital complications and mortality in patients with AMI. Materials and methods: Study sample included patients with AMI admitted to the CCU at Tishreen University Hospital-Latakia –Syria from April 2020 to April 2021. PLR was calculated from complete blood count for all patients. The study population was divided into tertiles based on their admission PLR. Patients having values in the third tertile was defined as the high PLR group (n=33) and those having values in the lower 2 tertiles were defined as the low PLR group (n=66). Results: 99 patients were included, 75 were male (75.8%) and the median age was 59. In-hospital mortality was significantly higher among patients in the upper PLR tertile when compared with the middle and lower PLR tertile groups (p=0.0001). Using a cutoff point of 140.5, the PLR predicted in-hospital mortality with a sensitivity of 83.3% and specificity of 82.8%, and PLR values were positively correlated with GRACE score (P=0.0001). According to multivariant analysis any increase in the value of PLR upon admission is associated with an increase of in-hospital mortality (Or=3.3, P=0.0001), arrhythmias (Or=4.1, P=0.0001) and cardiogenic shock (Or=3.2, P=0.002). Conclusions: PLR is an inexpensive and readily available biomarker that may be useful for cardiac risk stratification in patients with acute myocardial infarction.[Full Text Article]