Key result
A platelet-lymphocyte ratio greater than 165.9 was associated with a more than 12-fold increased risk of bleeding (HR 12.27) in patients with nonvalvular atrial fibrillation receiving warfarin.
Why the study?
The study investigated the role of the platelet-lymphocyte ratio in predicting bleeding risk, its relationship with thromboembolic and bleeding risk scores, and its predictive value for patients in the therapeutic INR range with nonvalvular atrial fibrillation.
Does platelet-lymphocyte ratio (PLR) predict bleeding risk in patients with nonvalvular atrial fibrillation on warfarin?
Cohort (n=228)
No
Does platelet-lymphocyte ratio (PLR) predict bleeding risk in patients with nonvalvular atrial fibrillation on warfarin?
Hazard Ratio: 12.27 (95% CI 5.74–26.21)
p-value: p=<0.001
The platelet-lymphocyte ratio (PLR) is a readily available biomarker that significantly predicts bleeding risk and correlates with CHA2DS2-VASc and HAS-BLED scores in patients with nonvalvular atrial fibrillation on warfarin.
May aid bleeding risk stratification in NVAF; leaves open incremental value over existing scores pending prospective validation.
Objective: The primary aim of this study was to investigate the role of platelet-lymphocyte ratio (PLR) to predict bleeding risk in nonvalvular atrial fibrillation (NVAF). Secondary aim was to determine the possible relation between PLR and thromboembolic and bleeding risk scores. Tertiary aim was to evaluate the predictive value of PLR for the patients in the therapeutic international normalized ratio (INR) range. Method: PLR was calculated from the complete blood count of 228 patients who were under warfarin management for NVAF. The patients were called and it was questioned whether they had experienced the bleeding event within six months after measurement of the PLR values. Results: Bleeding event was observed in 48 patients after the PLR was calculated. It was found significantly correlation between PLR and CHA2DVAS2C (p 165,9 was determined significant indicator for bleeding (p<0.001) and showed more than a 12-fold increased risk of bleeding (12.27, [5.74-26.21]). Conclusions: The results of the present study indicate that the PLR might be a useful parameter to detect the risk of bleeding. To our knowledge, this is the first study demonstrating the correlation of PLR with both CHA2DS2-VASc and HAS-BLED risk scores. PLR may also predict the patients within the therapeutic INR range.
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Coşansu et al. (2020) conducted a cohort in Nonvalvular Atrial Fibrillation (n=228). Platelet-Lymphocyte Ratio (PLR) > 165.9 vs. Lower Platelet-Lymphocyte Ratio was evaluated on Bleeding event within six months (HR 12.27, 95% CI 5.74-26.21, p=<0.001). A platelet-lymphocyte ratio greater than 165.9 was associated with a more than 12-fold increased risk of bleeding (HR 12.27) in patients with nonvalvular atrial fibrillation receiving warfarin.
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