Objective: To investigate the usefulness of PLR in predicting severity and complexity of coronary atherosclerosis as assessed by the SXscore in patients with Non ST elevation myocardial infarction NSTEMI who underwent nonurgent coronary angiography (CA).
Background: In NSTEMI patients, there is a debate whether early angiography and revascularization is beneficial compared with a more conservative approach. Platelet to lymphocyte ratio (PLR) is a new prognostic marker that gives idea about inflammation and aggregation pathways and may predict coronary atherosclerotic burden. PLR can be used to select patients who should go under angiography earlier due to excessive ischemic load.
Methods: We retrospectively evaluated 111 consecutive patients who presented with NSTEMI and underwent non-urgent coronary angiography between July 2016 and March 2017. The PLR was calculated as the ratio of the platelet count to the lymphocyte count. The Syntax scores SX of all patients were calculated. A low SX score was defined as ≤ 22, an intermediate score as 23 to 32, and a high score as ≥ 33.
Results: 92 patients (82.8%) had low SX scores (≤ 22), 19 patients (17.1%) had intermediate to high SX scores (≥ 23). Patients in the intermediate to high SX score group had significantly higher PLR 263 (219-366) vs. 117 (82-144.5) p<0.001. In ROC analysis PLR of 178 or lower predicted a low SX score defined as ≤ 22 with a sensitivity of 91.3% and specificity of 100%.
Conclusion: In patients with NSTEMI, PLR has significant association with syntax score and may be used for risk stratification and assessing optimal timing for coronary angiography.