The Utility the Platelet-to-Lymphocyte Ratio in Predicting Angiographic Reflow after Primary Percutaneous Coronary Intervention in Patients with Acute ST- Segment Elevation Myocardial Infarction

Abstract
Background: Impaired coronary flow after Primary Per-cutaneous Coronary Intervention (PPCI) is associated with long term morbidity and mortality in patients with acute ST-segment Elevation Myocardial Infarction (STEMI). Recent studies have demonstrated that Platelet-to-Lymphocyte Ratio (PLR) is associated with adverse cardiovascular outcomes. We want to determine the relation between admission (PLR) and angiographic reflow following PPCI.
Material and Methods: A total of 72 patients with STEMI-(age 55±10 years; 91% men) occurring within 12 hours of the onset of symptoms who underwent PPCI were enrolled. The PLR and other laboratory parameters (CKMB, creatinine, heamoglobin) were measured before Primary Percutaneous Coronary Intervention (PPCI). The patients were divided into 2 groups based on the post-intervention Thrombolysis In Myocardial Infarction (TIMI) flow grade: Normal reflow group (defined as post-intervention TIMI grade 3 flow) and no-reflow group (consisted of both patients with angiographic no-reflow defined as post-intervention TIMI grade 0-1 flow and slow flow defined as post-intervention TIMI grade 2 flow).
Results: There were 31 patients (22.5%) in no-reflow group (age 54±10 years and 93.5% male) and 41 patients in normal reflow group (age 55±11 years and 37% male). No-reflow group had significantly higher PLR compared to normal reflow group (196-262) versus (139-180), p=0.009). In logistic regression analysis, PLR (Odds Ratio (OR): 1.008, 95% Confidence Interval (CI):1.002-1.014, p<0.001) and were independent predictors of no-reflow after PPCI.
Conclusion: Pre-intervention PLR is a strong and inde-pendent predictor of slow flow/no-reflow following PPCI in patients with acute STEMI.