Platelet-To-Lymphocyte Ratio Efficiency in Predicting Major Adverse Cardiovascular Events After Percutaneous Coronary Intervention in Acute Coronary Syndromes: A Meta-Analysis.

IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Reviews in cardiovascular medicine Pub Date : 2025-05-21 eCollection Date: 2025-05-01 DOI:10.31083/RCM27942

He Wang, Tuerxun Zulikaier, Balati Yumaierjiang, Saiqi Lyu, Pengyi He

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引用次数: 0

Abstract

Background: The platelet-to-lymphocyte ratio (PLR) is applied as a potential first-line prognostic predictor for many cardiovascular diseases due to its simplicity and accessibility. This meta-analysis aimed to quantify the predictive power of PLR for major adverse cardiovascular events (MACEs) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI), explore its predictive efficacy in different populations, and identify other potential influencing factors.

Methods: PubMed, Embase, Cochrane Library, and Web of Science databases were comprehensively searched for eligible studies until February 7, 2025, based on the inclusion and exclusion criteria. The Newcastle-Ottawa scale (NOS) was employed for quality assessment. Sensitivity, specificity, summary receiving operating characteristic (SROC) and area under the curve (AUC) were combined using Stata 15.1 and Meta-DiSc software. Meta-regression analyses, subgroup analyses, threshold effect analyses, sensitivity analyses, and publication bias tests were performed.

Results: Nine studies (7174 patients) were enrolled. High PLR could predict MACEs in ACS patients undergoing PCI, with 0.68 sensitivity (95% CI, 0.60-0.76), 0.65 specificity (95% CI, 0.57-0.73), and 0.72 AUC (95% CI, 0.68-0.76). Subgroup analyses noted that PLR better predicted MACEs after PCI in ACS patients in the subgroup with a higher proportion of female patients and the subset aged >60 years. Meta-regression analyses unveiled that study type (p < 0.01) and PLR cutoff value (p < 0.01) might be sources of heterogeneity in the sensitivity analyses, while the mean age (p < 0.001) and sex ratio (p = 0.05) might be sources of heterogeneity in the specificity analyses.

Conclusions: High PLR levels have favorable values in predicting in-hospital and long-term MACEs after PCI in ACS patients. The PLR had greater sensitivity and an improved ability to identify risk in patients aged >60 years and the subgroup with a higher proportion of women and was also more sensitive to in-hospital MACEs.

The prospero registration: No. CRD42024537586, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024537586.

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血小板与淋巴细胞比值在急性冠脉综合征经皮冠状动脉介入治疗后预测主要不良心血管事件的有效性：一项荟萃分析。

背景：血小板与淋巴细胞比率（PLR）由于其简单和可及性，被用作许多心血管疾病的潜在一线预后预测指标。本荟萃分析旨在量化PLR对急性冠脉综合征（ACS）经皮冠状动脉介入治疗（PCI）患者主要心血管不良事件（mace）的预测能力，探讨其在不同人群中的预测效果，并确定其他潜在的影响因素。方法：根据纳入和排除标准，综合检索PubMed、Embase、Cochrane Library和Web of Science数据库，直至2025年2月7日。采用纽卡斯尔-渥太华量表（NOS）进行质量评价。采用Stata 15.1和Meta-DiSc软件对敏感性、特异性、总接受工作特征（SROC）和曲线下面积（AUC）进行综合分析。进行meta回归分析、亚组分析、阈值效应分析、敏感性分析和发表偏倚检验。结果：纳入9项研究（7174例患者）。高PLR可以预测行PCI的ACS患者的mace，敏感性为0.68 (95% CI, 0.60-0.76)，特异性为0.65 (95% CI, 0.57-0.73)， AUC为0.72 （95% CI, 0.68-0.76）。亚组分析指出，在女性患者比例较高的亚组和年龄在60 - 60岁的亚组中，PLR能更好地预测ACS患者PCI后的mace。meta回归分析显示，研究类型（p < 0.01）和PLR截断值（p < 0.01）可能是敏感性分析的异质性来源，而平均年龄（p < 0.001）和性别比例（p = 0.05）可能是特异性分析的异质性来源。结论：高PLR水平对预测ACS患者PCI术后住院及远期mace有有利价值。PLR在60 ~ 60岁患者和女性比例较高的亚组中具有更高的敏感性和识别风险的能力，并且对院内mace也更敏感。普洛斯彼罗登记：没有。CRD42024537586, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024537586。

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来源期刊

Reviews in cardiovascular medicine 医学-心血管系统

CiteScore

2.70

自引率

3.70%

发文量

377

审稿时长

1 months

期刊介绍： RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.