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Anatol J Cardiol. 2015 Apr;15(4):277-83. doi: 10.5152/akd.2014.5366. Epub 2014 Apr 8.

Platelet-to-lymphocyte ratio is a predictor of in-hospital mortality patients with acute coronary syndrome.

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Department of Cardiology, Faculty of Medicine, Dicle University; Diyarbakır-Turkey.



Platelets and inflammatory cells are vital elements of acute coronary syndromes (ACS). Recent studies have shown that the platelet-to-lymphocyte ratio (PLR) is associated with several malignancies; however, there are not enough data in cardiovascular diseases. Therefore, the aim of this study was to explore the association between PLR and in-hospital mortality in patients with ACS.


We retrospectively collected patients with ACS undergoing coronary angiography. Total and differential leukocyte counts were measured by an automated hematology analyzer.


This study is single-centered and observational. In total, 587 patients with a mean age of 61.8±13.1 years (68.4% male) were enrolled in the study. Patients were divided into 3 tertiles based on PLR levels. In-hospital mortality was significantly higher among patients in the upper PLR tertile when compared with the middle and lower PLR tertile groups [29 (14.8%) vs. 17 (8.7%) and 2 (1.0%); p<0.001]. In the multiple logistic regression analysis, a high level of PLR was an independent predictor of in-hospital mortality, together with age, total leukocyte count, and creatinine. Using a cutoff point of 142, the PLR predicted in-hospital mortality with a sensitivity of 69% and specificity of 63%.


Different from other inflammatory markers and assays, PLR is an inexpensive and readily available biomarker that may be useful for cardiac risk stratification in patients with ACS.

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