Mean Platelet-Lymphocyte Volume Ratio as Predictors of Coronary Artery Severity in Chronic Coronary Syndrome

Authors

  • Friska Wijaya Department of Medicine, Faculty of Medicine, Diponegoro University, Semarang, Indonesia, Indonesia
  • Charles Limantoro Division of Cardiology, Departement of Internal Medicine, Faculty of Medicine Diponegoro University – dr. Kariadi Hospital, Semarang, Indonesia, Indonesia
  • Indah Fitria Department of Internal Medicine, Faculty of Medicine Diponegoro University – dr. Kariadi Hospital, Semarang, Indonesia, Indonesia
  • Catharina Suharti Division of Hematology and Oncology Medic, Departement of Internal Medicine, Faculty of Medicine Diponegoro University – dr. Kariadi Hospital, Semarang, Indonesia, Indonesia
  • Trilaksana Nugroho Departement of Ophtamology, Faculty of Medicine Diponegoro University – dr. Kariadi Hospital, Semarang, Indonesia, Indonesia

DOI:

https://doi.org/10.36408/mhjcm.v10i1.813

Keywords:

Chronic Coronary Syndrome, ChroGensini Score, Mean Platelet Volume, Mean Platelet Volume to Lymphocyte Ratio, Platelet Lymphocyte Ratio.

Abstract

BACKGROUND: The increase in platelet aggregation and inflammation play an essential role in atherosclerosis. Furthermore, the level of activity depends on their size, with larger platelets facilitating the thrombosis process. Severe Coronary Artery Disease (CAD) is associated with low lymphocyte count. It is also linked with Mean platelet volume [MPV], Platelet Lymphocyte Ratio [PLR], and Mean Platelet Volume to Lymphocyte Ratio [MPVLR].

OBJECTIVE:  This study aims to investigate MPV, PLR, and MPVLR as predictors of the severity of Coronary Artery Lesion in Chronic Coronary Syndrome (CCS) using the Gensini score.

METHOD: This is a cross sectional study conducted in Dr. Kariadi General Hospital, involving a total sample of 68 respondents. Furthermore, CCS were evaluated before conducting coronary angiography. The study comprises of two group of patients divided according to their Gensini scores, namely mild and severe, for ≤ 20 and > 20, respectively. MPV, PLR, and MPVLR were then compared between the two groups.

RESULT: At a cut-off level of 3.4, MPVLR predicted the coronary artery severity with a sensitivity, specificity, positive predictive value (PPV), and negative predictive value of 80%, 50%, 82%, and 47% (area under the curve [AUC] 0.67; 95% confidence interval [CI], 0.52-0.82; p 0.029). Meanwhile, its value ≥3.4 has OR 1.55; 95% CI, 0.99-2.43; p 0.034.

CONCLUSION: This study conclude that MPVLR ≥3.4 can be used as a predictor of Coronary Artery Lesion Severity based on the Gensini score in CCS cases.

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References

  1. Roth G, Mensah G, Johnson C. Global Burden of Cardiovascular Diseases and Risk Factors. J Am Coll Cardiol. 2020;76:2982-30.
  2. Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, et al. ESC guidelines on the management of stable coronary artery disease. Eur Heart J. 2013;34(38):2949–3003.
  3. Kementerian Kesehatan RI [Internet]. Hasil Utama Rikesdas 2018. Jakarta; 2018.
  4. Andersson J, Libby P, Hansson GK. Adaptive immunity and atherosclerosis. Clin Immunol. 2010;134(1):33–46.
  5. Chatterjee M,  Gawaz    Platelets  in  Atherosclerosis. Platelets  Thromb Non-Thrombotic Disord Pathophysiol Pharmacol Ther an Updat. 2017 Mar;993–1013.
  6. Kodiatte TA, Manikyam UK, Rao SB, Jagadish TM, Reddy M, Lingaiah HKM, et al. Mean Platelet Volume in Type 2 Diabetes Mellitus. J Lab Physicians. 2012 Jan;4(1):5.
  7. Taleb S. L’inflammation dans l’athérosclérose. Arch Cardiovasc Dis. 2016;109(12):708–15.
  8. 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(1):17.
  9. Kaushansky K. Megakaryocytes and Platelets. USA: Lippincott Williams and Wilkins; 2004.
  10. Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean platelet volume (MPV): New perspectives for an old marker in the course and prognosis of inflammatory conditions. Mediators Inflamm. 2019 Apr;1-14.
  11. Handtke S, Thiele T. Large and small platelets—(When) do they differ? J Thromb Haemost. 2020 Jun;18(6):1256–67.
  12. Sansanayudh, N., Anothaisintawee, T., Muntham, D., McEvoy, M., Attia, J., & Thakkinstian A. Mean platelet volume and coronary artery disease: a systematic review and meta-analysis. Int J Cardiol. 2014 Aug;175(3):433–40.
  13. Uysal HB, Dağlı B, Akgüllü C, Avcil M, Zencir C, Ayhan M, et al. Blood count parameters can predict the severity of coronary artery disease. Korean J Intern Med. 2016;31(6):1093–100.
  14. Murat SN, Duran M, Kalay N, Gunebakmaz O, Akpek M, Doger C, et al. Relation Between Mean Platelet Volume and Severity of Atherosclerosis in Patients With Acute Coronary Syndromes. 2012 Feb;64(2):131–6.
  15. Bodí V, Sanchis J, Núñez J, Rumiz E, Mainar L, López-Lereu MP, et al. Post-Reperfusion Lymphopenia and Microvascular Obstruction in ST-Segment Elevation Acute Myocardial Infarction. Rev Española Cardiol (English Ed). 2009 Oct;62(10):1109–17.
  16. Chu S, Becker R, Berger P, Bhatt D, Eikelboom J, Konkle B, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost. 2010 Jan;8(1):148–56.
  17. Qiu Z, Jiang Y, Jiang X, Yang R, Wu Y, Xu Y, et al. Relationship Between Platelet to Lymphocyte Ratio and Stable Coronary Artery Disease: Meta-Analysis of Observational Studies. 2020 Jul;71(10):909–15.
  18. Wahyuni I, Wijaya I, Sukrisman L, Nasution S, Rumende C. Diagnostic Accuracy of Platelet/Lymphocyte Ratio for Screening Complex Coronary Lesion in Different Age Group of Patients with Acute Coronary Syndrome - PubMed. Acta Med Indones. 2018.p. 50(3):185-192.
  19. Ornek E, Kurtul A. Relationship of mean platelet volume to lymphocyte ratio and coronary collateral circulation in patients with stable angina pectoris. Coron Artery Dis. 2017;28(6):492–7.
  20. Hudzik B, Szkodziński J, Lekston A, Gierlotka M, Poloński L, Gąsior M. Mean platelet volume-to-lymphocyte ratio: a novel marker of poor short- and long-term prognosis in patients with diabetes mellitus and acute myocardial infarction. J Diabetes Complications. 2016 Aug;30(6):1097–102.
  21. Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol. 1983;51(3):606
  22. Akboga M, Canpolat U, Yayla C, Ozcan F, Ozeke O, Topaloglu S, et al. Association of Platelet to Lymphocyte Ratio With Inflammation and Severity of Coronary Atherosclerosis in Patients With Stable Coronary Artery Disease. Angiology. 2016 Jan;67(1):89–95
  23. 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. Anadolu Kardiyol Derg. 2015;15(8):640–7
  24. Hotchkiss RS KI. The pathophysiology and treatment of sepsis. N Engl J Med. 2003;348(2):138
  25. Le Blanc J LM. Platelet Function in Aging. Front Cardiovasc Med. 2019
  26. Lin Y, Chen X, Xu X. Utility of mean platelet volume to predict the prevalence of coronary artery disease on coronary angiography in patients with stable angina. Coron Artery Dis. 2019;30(8):615–20
  27. Trakarnwijitr, I., Li, B., Adams, H., Layland, J., Garlick, J., & Wilson A. Age modulates the relationship between platelet-to-lymphocyte ratio and coronary artery disease. Int J Cardiol. 2017 Dec;248:349–54
  28. De Luca G, Verdoia M, Cassetti E, Schaffer A, Di Giovine G, Bertoni A, Di Vito C, Sampietro S, Aimaretti G, Bellomo G, Marino P SFNAS (NAS) group. Mean platelet volume is not associated with platelet reactivity and the extent of coronary artery disease in diabetic patients. Blood Coagul Fibrinolysis. 2013;Sep;24(6)
  29. Barbaux SC, Blankenberg S, Rupprecht HJ, Francomme C, Bickel C, Hafner G, Nicaud V, Meyer J, Cambien F TL. Association between P-selectin gene polymorphisms and soluble P-selectin levels and their relation to coronary artery disease. Arter Thromb Vasc Biol. 21(10):166
  30. Song C, Wu G, Chang S BL. Plasma P-selectin level is associated with severity of coronary heart disease in Chinese Han population. J Int Med Res. 2020;48(6):3000
  31. Werner GS, Ferrari M, Heinke S, Kuethe F, Surber R, Richartz BM FH. Angiographic assessment of collateral connections in comparison with invasively determined collateral function in chronic coronary occlusions. Circulation. 2003;Apr 22;107
  32. Açar G, Kalkan ME, Avci A, Alizade E, Tabakci MM, Toprak C, et al. The Relation of Platelet-Lymphocyte Ratio and Coronary Collateral Circulation in Patients With Stable Angina Pectoris and Chronic Total Occlusion. Clin Appl Thromb. 2015;21(5):462–8
  33. Akın F, Ayça B, Çelik Ö, Şahin C. Predictors of poor coronary collateral development in patients with stable coronary artery disease: Neutrophil-to-lymphocyte ratio and platelets. Anadolu Kardiyol Derg. 2015;15(3):218–23

Additional Files

Published

2023-03-31

How to Cite

1.
Wijaya F, Limantoro C, Fitria I, Suharti C, Nugroho T. Mean Platelet-Lymphocyte Volume Ratio as Predictors of Coronary Artery Severity in Chronic Coronary Syndrome. Medica Hospitalia J. Clin. Med. [Internet]. 2023 Mar. 31 [cited 2024 Dec. 26];10(1):16-25. Available from: http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/813

Issue

Vol. 10 No. 1 (2023): Med Hosp; March 2023

Section

Original Article

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