The Relation between Platelet to Lymphocyte Ratio with Severity And Complexity of Coronary Heart Disease in Patients with Acute ST- Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Abstract
Background: Coronary Artery Disease (CAD) is charac-terized pathologically by atherosclerosis formation which is the predominant cause of death. The chronic inflammatory response is associated with production of platelets and lym-phocytes, elevated platelet counts accelerate atherosclerosis formation, progression, and destabilization of atherosclerotic plaques. The ratio of absolute number of platelets to the number of lymphocyte (PLR) act as an effective biomarker to predict the severity of CAD.
Aim of Study: To study the relation between Platelet to Lymphocyte Ratio (PLR) with severity and complexity of coronary heart disease in patients with acute ST-segment Elevation Myocardial Infarction (STEMI) undergoing primary Percutaneous Coronary Intervention (PCI).
Methods: This study was conducted on 100 patients diagnosed with STEMI and who underwent primary PCI in Tanta University Hospitals, Cardiovascular Department, from June 2017 to December 2017. To assess the correlation between platelet to lymphocyte parameters and severity of CAD, the sample was divided according to the angiographic severity of CAD by using Gensini score into three groups, Group I Gensini score ranged from zero to 50, Group II Gensini score ranged from 50 to 100 and Group III Gensini score more than 100.
Results: Patients with high PLR showed significant tach-ycardia at onset of admission, higher glucose level, higher Killip class II-IV, lower final angiographic TIMI flow, higher Gens iniscore, higher serum LDL level, lower HDL levels and higher triglycerides level, higher all the composite end-points of Major Adverse Cardiovascular Events (MACE) including death, reinfarction and Congestive Heart Failure (CHF).
Conclusion: Platelets to lymphocytes ratio is an independ-ent prognostic factor for severity and complexity of CAD in patients with STEMI undergoing primary PCI intervention by using Gensini score.