BACKGROUND: Studies have shown that inflammation plays a role in the pathogenesis of acute coronary syndrome (ACS). The use of platelet-to-lymphocyte ratio (PLR) as a marker for inflammatory conditions such as malignancy, systemic lupus erythematosus, and rheumatoid arthritis has been demonstrated in several studies. The aim of this study is to determine whether an elevated PLR taken on admission is associated with in-hospital mortality and major adverse cardiac events among ACS patients. METHODS: This is a single-center, retrospective correlational study. It included all ACS STsegment elevation myocardial infarction and non–ST-segment elevation myocardial infarction adult patients admitted from January 2011 to December 2020. Complete blood count on admission was used to derive the PLR. Patient’s course in the ward was reviewed for development of adverse clinical outcomes such as in-hospital mortality, arrhythmias, heart failure, cardiogenic shock, and reinfarction. Primary outcome for this study was in-hospital mortality, and the secondary outcomes were the development of other complications previously mentioned. Optimal cutoff value associated with in-hospital mortality was determined using receiver operating characteristic curve. RESULTS: A total of 342 patients were included in the study. Forty-three (12.57%) of the sample had in-hospital mortality and was noted to have higher PLR compared with patients who did not develop complications. Univariate logistic regression analysis showed a significant relationship between a high PLR and occurrence of in-hospital mortality (P = 0.0039). The optimal cutoff value of PLR that can predict in-hospital mortality is 165, with 52.17% sensitivity, 56.76% specificity, and an area under the curve of 59.69%. On the other hand, a high PLR did not show association with the development of complications during the hospital stay. CONCLUSION A PLR of >165 is a cheap, readily available marker that can be used to predict in-hospital mortality among Filipino patients with ACS.
Acute Coronary Syndrome