Correlation Of Platelet-To-Lymphocyte Ratio And Troponin I Levels In Patients With St-Elevation Myocardial Infarction: Correlation Of Platelet-To-Lymphocyte Ratio And Troponin I Levels In Patients With St-Elevation Myocardial Infarction

Tamariska Evelyn; Pipin Ardhianto; Dwi Retnoningrum; Mochamad Ali Sobirin

doi:10.36408/mhjcm.v9i3.804

Authors

Tamariska Evelyn Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia , Indonesia
Pipin Ardhianto Department of Cardiology and Vascular Medicine Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia, Indonesia
Dwi Retnoningrum Department of Clinical Pathology Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia, Indonesia
Mochamad Ali Sobirin Department of Cardiology and Vascular Medicine Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia, Indonesia

DOI:

https://doi.org/10.36408/mhjcm.v9i3.804

Keywords:

Platelet-to-lymphocyte ratio; ST-segment elevation myocardial infarction; troponin I

Abstract

INTRODUCTION: Platelet and lymphocyte are significant in acute myocardial infarction (AMI) pathogenesis. Platelet-lymphocyte ratio (PLR) is a systemic biomarker which indicates thrombosis and inflammation. The diagnosis of AMI can be made by detecting elevated blood troponin I levels. The correlation between PLR and troponin I levels in ST-segment elevation myocardial infarction (STEMI) patients has not been widely known.

AIM : The objective of this study is to determine the correlation between PLR and troponin I levels in STEMI patients.

METHODS : This study was a cross-sectional study which data were obtained from the medical records of patients with STEMI admitted to Dr. Kariadi General Hospital Semarang from 2019 to 2020. Serum Troponin I levels were measured with Enzyme-Linked Fluorescent Assay (ELFA) method in less than 24 hours from symptoms onset. Complete blood counts were performed immediately on hospital admission. Correlations between variables were obtained using Spearman's test.

RESULTS : A total of 28 STEMI patients were included, 82.1% were male, mean age was 55.81 ± 2.13 years old. Mean symptoms onset was 7.52 ± 0.81 hours prior to admission. Mean PLR and troponin I levels were 233.32 ± 25.54 and 14.44 ± 3.16 μg/l, respectively. A moderately significant correlation was detected between troponin I levels and PLR in STEMI patients (r=0.333; p=0.042). Symptoms onset in STEMI patients had significant correlation to troponin I levels (r=0.596; p=0.001).

CONCLUSION : A moderate positive correlation between PLR and troponin I levels is observed within 24 hours from symptoms onset in STEMI patients.

KEYWORDS: Platelet-to-lymphocyte ratio; ST-segment elevation myocardial infarction; troponin I

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References

Kementerian Kesehatan Republik Indonesia. Buletin Penyakit Tidak Menular [Internet]. 2012. Available from: http://www.depkes.go.id/download.php?file=download/pusdatin/buletin/buletin-ptm.pdf

Dinas Kesehatan Kota Semarang. Profil Kesehatan 2019 [Internet]. Profil Kesehatan Kota Semarang Tahun 2019. 2020. Available from: http://www.dinkes.semarangkota.go.id

Anderson JL. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: A report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013;127(4):362–425.

Lilly LS, Sabatine MS, Ree J-W. Acute Coronary Syndromes. In: Pathophysiology of Heart Disease : A Collaborative Project of Medical Students and Faculty. Baltimore: Wolters Kluwer/Lippincott Williams & Wilkins; 2011. p. 161–89.

Pasalic L, Wang SSY, Chen VMY. Platelets as biomarkers of coronary artery disease. Semin Thromb Hemost. 2016;42(3):223–33.

Núñez J, Núñez E, Bodí V, Sanchis J, Mainar L, Miñana G, et al. Low lymphocyte count in acute phase of ST-segment elevation myocardial infarction predicts long-term recurrent myocardial infarction. Coron Artery Dis. 2010;21(1):1–7.

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(7):972–8.

Ugur M, Gul M, Bozbay M, Cicek G, Uyarel H, Koroglu B, et al. The relationship between platelet to lymphocyte ratio and the clinical outcomes in ST elevation myocardial infarction underwent primary coronary intervention. Blood Coagul Fibrinolysis. 2014;25(8):806–11.

Dong G, Huang A, Liu L. Platelet-to-lymphocyte ratio and prognosis in STEMI: A meta-analysis. Eur J Clin Invest. 2020;(June):1–10.

Temiz A, Gazi E, Güngör Ö, Barutçu A, Altun B, Bekler A, et al. Platelet/lymphocyte ratio and risk of in-hospital mortality in patients with ST-elevated myocardial infarction. Med Sci Monit. 2014;20:660–5.

Shawky A, Radwan H. The prognostic value of platelet–lymphocyte ratio (PLR) in patients with non ST segment elevation myocardial infarction (NSTEMI). Cardiol Vasc Res. 2018;2(2):1–5.

Daubert MA, Jeremias A. The utility of troponin measurement to detect myocardial infarction: Review of the current findings. Vasc Health Risk Manag. 2010;6(1):691–9.

Hallén J. Troponin for the estimation of infarct size: What have we learned? Cardiology. 2012;121(3):204–12.

Friska O, Tristina N, Suraya N. Uji sensitivitas dan spesifisitas troponin I dan troponin T sebagai penanda biokimia jantung untuk menegakkan diagnosis acute myocardial infarction (AMI). Indones J Clin Pathol Med Lab. 2008;14(3):106–8.

Younger JF, Plein S, Barth J, Ridgway JP, Ball SG, Greenwood JP. Troponin-I concentration 72 h after myocardial infarction correlates with infarct size and presence of microvascular obstruction. Heart. 2007;93(12):1547–51.

Panteghini M, Bonetti G, Pagani F, Stefini F, Giubbini R, Cuccia C. Measurement of troponin I 48 h after admission as a tool to rule out impaired left ventricular function in patients with a first myocardial infarction. Clin Chem Lab Med. 2005;43(8):848–54.

Saleh M, Ambrose JA. Understanding myocardial infarction. F1000Research. 2018;7:1–8.

Harun H, Bahrun U, Darmawaty E. Platelet-lymphocyte ratio (PLR) markers in acute coronary syndrome. Indones J Clin Pathol Med Lab. 2016;23(1):7–11.

Setianingrum E, Purwanto A. The difference between absolute neutrophils, neutrophil/lymphocyte ratio and platelet lymphocyte ratio in normal, NSTEMI, STEMI Patients. Indones J Clin Pathol Med Lab. 2019;25(3):268–73.

Karakurt A, Yildiz C. Predictive values of inflammatory cell ratios for complexity of coronary artery disease in patients with acute coronary syndrome. Int J Cardiovasc Acad. 2018;4(4):70.

Ritschel VN, Seljeflot I, Arnesen H, Halvorsen S, Weiss T, Eritsland J, et al. IL-6 signalling in patients with acute ST-elevation myocardial infarction. Results Immunol. 2014;4(1):8–13.

Suárez-Barrientos A, López-Romero P, Vivas D, Castro-Ferreira F, Núñez-Gil I, Franco E, et al. Circadian variations of infarct size in acute myocardial infarction. Heart. 2011;97(12):970–6.

Scheiermann C, Kunisaki Y, Frenette PS. Circadian control of the immune system. Nat Rev Immunol. 2013;13(3):190–8.

Scheiermann C, Gibbs J, Ince L, Loudon A. Clocking in to immunity. Nat Rev Immunol. 2018;18(7):423–37.

Albackr HB, AlHabib KF, AlShamiri MQ, Ullah A, Al Subaie FA, Alghamdi AG, et al. Circadian rhythm and ST-segment elevation myocardial infarction: insights from the third gulf registry of acute coronary events (Gulf RACE-3Ps). Angiology. 2019;70(4):352–60.

Reiter R, Swingen C, Moore L, Henry TD, Traverse JH. Circadian dependence of infarct size and left ventricular function after ST elevation myocardial infarction. Circ Res. 2012;110(1):105–10.

Kamińska J, Koper OM, Siedlecka-Czykier E, Matowicka-Karna J, Bychowski J, Kemona H. The utility of inflammation and platelet biomarkers in patients with acute coronary syndromes. Saudi J Biol Sci. 2018;25(7):1263–71.

Gawaz M. Role of platelets in coronary thrombosis and reperfusion of ischemic myocardium. Cardiovasc Res. 2004;61(3):498–511.

Mailoa AB, Adhipireno P. Hubungan Antara Indeks Trombosit (Jumlah Trombosit, MPV, PDW, P-LCR) dengan CKMB dan Troponin Pada Pasien Sindrom Koroner Akut. Medica Hosp. 2018;5(2):85–8.

Badran HM, Fatah AA, Soltan G. Platelet/ lymphocyte ratio for prediction of no reflow phenomenon in ST elevation myocardial infarction managed with primary percutanous coronary intervention. J Clin Transl Res. 2020;6(1):20–6.

Yüksel M, Yıldız A, Oylumlu M, Akyüz A, Aydın M, Kaya H, et al. The association between platelet/lymphocyte ratio and coronary artery disease severity. Anatol J Cardiol. 2015;15(8):640–7.

Ozcan Cetin EH, Cetin MS, Aras D, Topaloglu S, Temizhan A, Kisacik HL, et al. Platelet to lymphocyte ratio as a prognostic marker of in-hospital and long-term major adverse cardiovascular events in ST-segment elevation myocardial infarction. Angiology. 2016;67(4):336–45.

Kurtul A, Yarlioglues M, Murat SN, Ergun G, Duran M, Kasapkara HA, et al. Usefulness of the platelet-to-lymphocyte ratio in predicting angiographic reflow after primary percutaneous coronary intervention in patients with acute st-segment elevation myocardial infarction. Am J Cardiol. 2014;114(3):342–7.

Correlation Of Platelet-To-Lymphocyte Ratio And Troponin I Levels In Patients With St-Elevation Myocardial Infarction