Key result
An increased platelet-to-lymphocyte ratio was an independent predictor of left ventricular thrombus formation (OR 1.011) in patients with anterior STEMI and left ventricular dysfunction.
Why the study?
Predictors of left ventricular thrombus formation are not well defined in the contemporary era, particularly in high-risk patients.
Does the platelet-to-lymphocyte ratio predict left ventricular thrombus formation in patients with anterior ST-elevation myocardial infarction and left ventricular dysfunction?
Case-Control (n=138)
No
Does the platelet-to-lymphocyte ratio predict left ventricular thrombus formation in patients with anterior ST-elevation myocardial infarction and left ventricular dysfunction?
An elevated platelet-to-lymphocyte ratio at admission is an independent predictor of early left ventricular thrombus formation in patients with anterior STEMI and left ventricular dysfunction undergoing primary PCI.
Answers are grounded in this paper and cite their sources.
May refine LVT risk stratification in anterior STEMI with LV dysfunction; hypothesis-generating and needs prospective validation before clinical adoption.
BACKGROUND: The predictors of left ventricular thrombus (LVT) formation are not well defined in the contemporary era, especially in those patients at high risk. We aimed to evaluate whether the platelet/lymphocyte ratio (PLR) is valuable in the determination of LVT formation in patients with anterior ST-elevation myocardial infarction (STEMI) and left ventricular (LV) dysfunction. METHODS: The LVT group (n = 46) was identified from anterior STEMI patients with LV dysfunction who were treated with primary percutaneous coronary intervention (PCI) from January 2017 to December 2019 at the China-Japan Union Hospital of Jilin University. The no-LVT group (n = 92) were also selected from the same batch of patients and were age- and sex-matched to the patients with LVT. The PLR was determined at admission and was calculated as the ratio of the platelet count to the lymphocyte count using the complete blood count. The presence of LVT was determined by echocardiography. RESULTS: The PLR were significantly higher in patients with LVT than in no-LVT group (p = 0.001). In a receiver operator characteristic curve (ROC) analysis, using a cut-off value of 118.07 (AUC 0.673, 95% CI: 0.574-0.771, P = 0.001), the PLR could independently predict the occurrence of LVT. Multivariate analysis showed that an increased PLR (OR = 1.011, 95% CI: 1.004-1.018, P = 0.002), the presence of a left ventricular aneurysm (OR = 46.350, 95% CI: 5.659-379.615, P < 0.001) and increased DTBT (OR = 1.005, 95% CI: 1.001-1.009, P = 0.012) were independent predictors of LVT formation. CONCLUSIONS: In acute anterior STEMI patients with LV dysfunction, an increased PLR and DTBT and the presence of an LV aneurysm were independent predictors of LVT formation. A larger prospective study is warranted to evaluate this result. TRIAL REGISTRATION: This study was registered (May 4, 2019) on Chinese Clinical Trial Registry ( ChiCTR-DDD-17011214 ).
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Zhang et al. (2020) conducted a case-control in Anterior ST-elevation myocardial infarction (STEMI) with left ventricular dysfunction (n=138). Platelet-to-lymphocyte ratio (PLR) vs. Lower PLR was evaluated on Left ventricular thrombus (LVT) formation (OR 1.011, 95% CI 1.004-1.018, p=0.002). An increased platelet-to-lymphocyte ratio was an independent predictor of left ventricular thrombus formation (OR 1.011) in patients with anterior STEMI and left ventricular dysfunction.
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