Abstract
Introduction. Various studies have concluded the association between various markers of inflammation with the clinical outcome in STEMI patients. However, most of these markers are quite expensive and not available in healthcare facilities. Hence, we aim to study the correlation between haemoglobin platelet ratio (HPR) and leucocyte platelet ratio (RPL) and the clinical outcomes of STEMI patients. Methods. This is a cross-sectional study performed in adult patients with STEMI who were hospitalized in Intensive Coronary Care Unit Cipto Mangunkusumo Hospital between January 2016 and October 2020. The data was analyzed by testing the correlation between HPR and LPR with SYNTAX-2 score. Results. There were 114 subjects in this study, with a mean age was 53.87 years and dominated by male (86.8%). We found no correlation between HPR and LPR with SYNTAX-2 Score. From the sub-group analysis, there was a moderate positive correlation between HPR and SYNTAX-2 score (r = 0.587; p= 0.005) and a strong positive correlation between LPR and SYNTAX-2 score (r = 0.606; p = 0.004) in subjects with normal body mass index (BMI). Additional results obtained a strong negative correlation between neutrophil lymphocyte ratio (NLR) with SYNTAX-2 score (r = -0.738; p= 0.0037) and a very strong negative correlation between platelet lymphocyte ratio (PLR) with SYNTAX-2 score (r= -0,857; p= 0,007) in subjects with low BMI. Conclusion. There is no correlation between HPR and LPR with SYNTAX-2 Score
References
1. WHO. Cardiovascular diseases fact sheets [Internet]. Geneva: WHO [cited 2020 Jan 26]. Available from: https://www.who.int/newsroom/fact-sheets/detail/cardiovascular-diseases-(cvds) 2. Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics-2019 update: a report from the American Heart Association. Circulation. 2019;139:56–66. 3. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2018;39:119–77. 4. Wibowo B. US-ASEAN round table discussion of cardiovascular. In: national program in providing better intervention cardiology services : challenges and priorities. Jakarta; 2019. 5. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth universal definition of myocardial infarction. J Am Coll Cardiol. 2018;72:2231–64. 6. Vogel B, Claessen BE, Arnold SV, Chan D, Cohen DJ, Giannitsis E, et al. ST-segment elevation myocardial infarction. Nat Rev Dis Prim. 2019;5:1–20. 7. Dharma S, Andriantoro H, Dakota I, Purnawan I, Pratama V, Isnanijah H, et al. Organisation of reperfusion therapy for STEMI in a developing country. Open Hear. 2015;2:e000240. 8. Studenčan M, Kovář F, Hricák V, Kurray P, Goncalvesová E, Šimková I, et al. Two-year survival of STEMI patients in Slovakia. An analysis of the SLOVak registry of Acute Coronary Syndromes (SLOVAKS). Cor Vasa. 2014;56:3–9. 9. Reimold FR, Levy MS. SYNTAX II in the “real world” – A practical approach to coronary risk-stratification. Catheter Cardiovasc Interv. 2018;92:48–9. 10. Yang H, Zhang L, Xu CH. Use of the SYNTAX score II to predict mortality in interventional cardiology. Medicine (Baltimore). 2019;98:e14043. 11. Islam S, Rahman A, Chowdhury AW, Ahmed M, Karmakar KK. SYNTAX score on procedural outcome among patient undergoing primary percutaneous coronary intervention. Bangladesh Heart J. 2017;34:5–10. 12. Kurniawan E, Ding FH, Zhang Q, Yang ZK, Hu J, Shen WF, et al. Predictive value of SYNTAX score II for clinical outcomes in octogenarian undergoing percutaneous coronary intervention. J Geriatr Cardiol. 2016;13:733–9. 13. Cid Alvarez AB, Gomez-Peña F, Redondo-Dieguez A, Avila A, López D, Sanmartin X, et al. Prognostic impact of the SYNTAX score II in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention: analysis of a fouryear all-comers registry. EuroIntervention. 2019;15:e796–803. 14. Karabağ Y, Çağdaş M, Rencuzogullari I, Karakoyun S, Artaç İ, İliş D, et al. Comparison of SYNTAX score II efficacy with SYNTAX score and TIMI risk score for predicting in-hospital and long-term mortality in patients with ST segment elevation myocardial infarction. Int J Cardiovasc Imaging. 2018;34:1165–75. 15. Escaned J, Collet C, Ryan N, De Maria GL, Walsh S, Sabate M, et al. Clinical outcomes of state-of-the-art percutaneous coronary revascularization in patients with de novo three vessel disease: 1-year results of the SYNTAX II study. Eur Heart J. 2017;38:3124–34. 16. Song Y, Gao Z, Tang X, Ma Y, Jiang P, Xu J, et al. Usefulness of the SYNTAX score II to validate 2-year outcomes in patients with complex coronary artery disease undergoing percutaneous coronary intervention: A large single-center study. Catheter Cardiovasc Interv. 2018;92:40–7. 17. Farooq V, Van Klaveren D, Steyerberg EW, Meliga E, Vergouwe Y, Chieffo A, et al. Anatomical and clinical characteristics to guide decision making between coronary artery bypass surgery and percutaneous coronary intervention for individual patients: Development and validation of SYNTAX score II. Lancet. 2013;381:639–50. 18. Sun XP, Li J, Zhu WW, Li DB, Chen H, Li HW, et al. Impact of Plateletto-Lymphocyte Ratio on Clinical Outcomes in Patients with STSegment Elevation Myocardial Infarction. Angiology. 2017;68:346– 53. 19. Acet H, Ertaş F, Bilik MZ, Akil MA, Özyurtlu F, Aydin M, et al. The relationship between neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and thrombolysis in myocardial infarction risk score in patients with ST elevation acute myocardial infarction before primary coronary intervention. Postep w Kardiol Interwencyjnej. 2015;11:126–35. 20. Madjid M, Fatemi O. Components of the complete blood count as risk predictors for coronary heart disease: In-depth review and update. Texas Hear Inst J. 2013;40:17–29. 21. Kounis NG, Soufras GD, Tsigkas G, Hahalis G. White blood cell counts, leukocyte ratios, and eosinophils as inflammatory markers in patients with coronary artery disease. Clin Appl Thromb. 2015;21:139–43. 22. Li H, Zhou Y, Ma Y, Han S, Zhou L. The prognostic value of the platelet-to-lymphocyte ratio in acute coronary syndrome: A systematic review and meta-analysis. Kardiol Pol. 2017;75:666–73. 23. Angkananard T, Anothaisintawee T, McEvoy M, Attia J, Thakkinstian A. Neutrophil Lymphocyte Ratio and Cardiovascular Disease Risk: A Systematic Review and Meta-Analysis. Biomed Res Int. 2018;2018: 2703518. 24. Ralapanawa U, Kumarasiri PVR, Jayawickreme KP, Kumarihamy P, Wijeratne Y, Ekanayake M, et al. Epidemiology and risk factors of patients with types of acute coronary syndrome presenting to a tertiary care hospital in Sri Lanka. BMC Cardiovasc Disord. 2019;19:1–9. 25. Loyeau A, Benamer H, Bataille S, Tepper S, Boche T, Lamhaut L, et al. Evolution of ST-elevation acute myocardial infarction prevalence by gender assessed age pyramid analysis—The Piramyd Study. J Clin Med. 2018;7:509. 26. Kappert K, Böhm M, Schmieder R, Schumacher H, Teo K, Yusuf S, et al. Impact of sex on cardiovascular outcome in patients at high cardiovascular risk: Analysis of the telmisartan randomized assessment study in ACE-intolerant subjects with cardiovascular disease (TRANSCEND) and the ongoing telmisartan alone and in combinatio. Circulation. 2012;126:934–41. 27. Mo C ju, Hu Z jian, Qin S zi, Chen H ping, Huang L, Li S, et al. Diagnostic value of platelet-lymphocyte ratio and hemoglobin-platelet ratio in patients with rectal cancer. J Clin Lab Anal. 2020;34:1–7. 28. Hu Z, Tan S, Chen S, Qin S, Chen H, Qin S, et al. Diagnostic value of hematological parameters platelet to lymphocyte ratio and hemoglobin to platelet ratio in patients with colon cancer. Clin Chim Acta. 2020;501:48–52. 29. Tang G, Zhen Y, Xie W, Wang Y, Chen F, Qin C, et al. Preoperative hemoglobin-platelet ratio can significantly predict progression and mortality outcomes in patients with T1G3 bladder cancer undergoing transurethral resection of bladder tumor. Oncotarget. 2018;9:18627–36. 30. Al Shahi H, Shimada K, Miyauchi K, Yoshihara T, Sai E, Shiozawa T, et al. Elevated circulating levels of inflammatory markers in patients with acute coronary syndrome. Int J Vasc Med. 2015;2015. 31. Yanai H, Yoshida H. Beneficial effects of adiponectin on glucose and lipid metabolism and atherosclerotic progression: Mechanisms and perspectives. Int J Mol Sci. 2019;20:1–25. 32. Kaiafa G, Kanellos I, Savopoulos C, Kakaletsis N, Giannakoulas G, Hatzitolios AI. Is anemia a new cardiovascular risk factor? Int J Cardiol. 2015;186:117–24. 33. Hong YJ, Jeong MH, Choi YH, Song JA, Kim DH, Lee KH, et al. Relation between anemia and vulnerable coronary plaque components in patients with acute coronary syndrome: Virtual histologyintravascular ultrasound analysis. J Korean Med Sci. 2012;27:370–6. 34. Ibrahim H, Kleiman NS. Platelet pathophysiology, pharmacology, and function in coronary artery disease. Coron Artery Dis. 2017;28:614–23. 35. Liu CW, Liao PC, Chen KC, Hsu JC, Li AH, Tu CM, et al. Baseline hemoglobin levels associated with one-year mortality in STsegment elevation myocardial infarction patients. Acta Cardiol Sin. 2016;32:656–66. 36. Greenberg G, Assali A, Vaknin-Assa H, Brosh D, Teplitsky I, Fuchs S, et al. Hematocrit Level as a marker of outcome in ST-segment elevation myocardial infarction. Am J Cardiol. 2010;105:435–40. 37. Budzianowski J, Pieszko K, Burchardt P, Rzeźniczak J, Hiczkiewicz J. The role of hematological indices in patients with acute coronary syndrome. Dis Markers. 2017;2017:3041565. 38. Dehghani MR, Rezaei Y, Taghipour-Sani L. White blood cell count to mean platelet volume ratio as a novel non-invasive marker predicting long-term outcomes in patients with non-ST elevation acute coronary syndrome. Cardiol J. 2015;22:437–45. 39. Abdulhadi B, Naranjo M, Krishnamoorthy P, Rangaswami J. White Blood Cell Count To Platelet Ratio: A Novel Biomarker For Predicting Outcomes in Patients On Circulatory Support Devices. Am Coll Cardiol. 2018;71:810. 40. Rocco B, Cappelliari G, Semolic A, Enrico C, Mario I, Roberta S, et al. The association between hematological parameters and insulin resistance is modified by body mass index- results from the NorthEast Italy MoMa population study. PLoS One. 2014;9:1–9. 41. Furuncuoǧlu Y, Tulgar S, Dogan AN, Cakar S, Tulgar YK, Cakiroglu B. How obesity affects the neutrophil/lymphocyte and platelet/ lymphocyte ratio, systemic immune-inflammatory index and platelet indices: A retrospective study. Eur Rev Med Pharmacol Sci. 2016;20:1300–6. 42. Ellulu MS, Patimah I, Khaza H, Rahmat A, Abed Y, Sci AM. Obesity and inflammation : the linking mechanism and the complications. Arch Med Sci. 2016;851–63. 43. Gregory AB, Lester KK, Gregory DM, Twells LK, Midodzi WK, Pearce NJ. The relationship between body mass index and the severity of coronary artery disease in patients referred for coronary angiography. Cardiol Res Pract. 2017;2017:5481671. 44. Li X, Ji Y, Kang J, Fang N. Association between blood neutrophil-tolymphocyte ratio and severity of coronary artery disease Evidence from 17 observational studies involving 7017 cases. Medicine (Baltimore). 2018;97:1–9. 45. Kurtul A, Murat SN, Yarlioglues M, Duran M, Ergun G, Acikgoz SK, et al. Association of platelet-to-lymphocyte ratio with severity and complexity of coronary artery disease in patients with acute coronary syndromes. Am J Cardiol. 2014;114:972–8. 46. Park D, Lee JH, Han S. Underweight: another risk factor for cardiovascular disease? Medicine (Baltimore). 2017;96(48):e8769. 47. Bucholz EM, Krumholz HA, Krumholz HM. Underweight, markers of cachexia, and mortality in acute myocardial infarction: a prospective cohort study of elderly medicare beneficiaries. PLoS Med. 2016;13:1–18. 48. Su W, Wang M, Zhu J, Li W, Ding X, Chen H, et al. Underweight predicts greater risk of cardiac mortality post acute myocardial infarction. Int Heart J. 2020;61:658–64. 49. Takele Y, Adem E, Getahun M, Tajebe F, Kiflie A, Hailu A, et al. Malnutrition in healthy individuals results in increased mixed cytokine profiles, altered neutrophil subsets and function. PLoS One. 2016;11:1–18.
Recommended Citation
Ikhsan, Muhammad; Nasution, Sally Aman; Rachman, Andhika; and Muhadi, Muhadi
(2021)
"Correlation of Haemoglobin Platelet Ratio (HPR) and LeukocytePlatelet Ratio (LPR) with SYNTAX-2 Score in STEMI Patients,"
Jurnal Penyakit Dalam Indonesia: Vol. 8:
Iss.
1, Article 5.
DOI: 10.7454/jpdi.v8i1.537
Available at:
https://scholarhub.ui.ac.id/jpdi/vol8/iss1/5