Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome

Objective: Platelets and inflammatory cells are vital elements of acute coronary syndromes (ACS). Recent studies have shown that the platelet-to-lymphocyte ratio (PLR) is associated with several malignancies; however, there are not enough data in cardiovascular diseases. Therefore, the aim of this study was to explore the association between PLR and in-hospital mortality in patients with ACS. Methods: We retrospectively collected patients with ACS undergoing coronary angiography. Total and differential leukocyte counts were measured by an automated hematology analyzer. Results: This study is single-centered and observational. In total, 587 patients with a mean age of 61.8 +/- 13.1 years (68.4% male) were enrolled in the study. Patients were divided into 3 tertiles based on PLR levels. In-hospital mortality was significantly higher among patients in the upper PLR tertile when compared with the middle and lower PLR tertile groups [29 (14.8%) vs. 17 (8.7%) and 2 (1.0%); p<0.001]. In the multiple logistic regression analysis, a high level of PLR was an independent predictor of in-hospital mortality, together with age, total leukocyte count, and creatinine. Using a cutoff point of 142, the PLR predicted in-hospital mortality with a sensitivity of 69% and specificity of 63%. Conclusion: Different from other inflammatory markers and assays, PLR is an inexpensive and readily available biomarker that may be useful for cardiac risk stratification in patients with ACS.