Usefulness of the platelet-to-lymphocyte ratio in predicting bare-metal stent restenosis

Objectives. Platelet-to-lymphocyte ratio (PLR) provides a simple method for assessment of inflammatory status. The aim of the present study was to investigate the predictive value of preprocedural PLR on development of in-stent restenosis in patients undergoing bare-metal stent (BMS) implantation. Design. Six hundred and seventy-five consecutive patients (mean age: 60.6 +/- 8.3, 66% men) who had undergone successful BMS implantation and additional coronary angiography for stable or unstable angina pectoris were analyzed. Mean period between 2 coronary angiographies was 14.3 +/- 3.4 months. Results. Patients were divided into tertiles based on preprocedural PLR. Restenosis occurred in 58 patients (26%) in the lowest tertile, in 82 (36%) in the middle tertile, and in 115 (51%) in the highest tertile (p < 0.001). Serum C-reactive protein levels were also significantly higher in patients in tertile 3 than in those in tertiles 1 and 2 (p < 0.001). Smoking, diabetes mellitus, high-density lipoprotein, stent length, preprocedural PLR, and C-reactive protein levels emerged as independent predictors of in-stent restenosis. In receiver-operating characteristics curve analysis, PLR > 122 had 81% sensitivity and 72% specificity in predicting in-stent restenosis. Conclusions. High preprocedural PLR is a powerful and independent predictor of BMS restenosis in patients with stable and unstable angina pectoris.