| BackgroundWith the prevalence of unhealthy lifestyles and the acceleration of the society’s aging process,the Prevalence and mortality of coronary heart disease rise rapidly.Despite tremendous progress in the prevention and treatment of coronary artery disease,it still faces enormous challenges.According to the summary of the "China Cardiovascular Disease Report 2017",China’s cardiovascular deaths accounted for more than 40%of the deaths of residents,ranking first,higher than cancer and other diseases.Although there are many methods for assessing the severity and poor prognosis of coronary artery disease,simpler and more effective predictive indicators are still urgently needed for clinical work.Therefore,studying new biomarkers predicting the severity of coronary heart disease and poor prognosis can help to accurately assess the condition and optimize treatment strategies and ultimately reduce mortality.ObjectivesPlatelet to lymphocyte ratio(PLR)has been recently reported as a valuable predictor of the severity or prognosis of coronary artery disease.However,the prognostic role of PLR in coronary artery disease remains controversial.The aim of this study was to evaluate the association between PLR and clinical outcomes of CAD patients through a meta-analysis.MethodsTwo investigators independently searched relevant literatures from PubMed,Embase and Chorane Library databases.In order to search more comprehensively,we also searched other ways such as Google Scholar.The Newcastle-Ottawa Scale(NOS)was used to assess each of the included studies quality by two independent authors.Risk Ratio(RR)and 95%confidence intervals(CIs)were considered as effect measures.Statistical heterogeneity was tested by Cochran’s Q statistic and I2 tests.Subgroup analysis and sensitivity analyses helped confirm the stability of our results and explored the sources of heterogeneities.Publication bias was detected by Begg’s and Egger’s test(p>0.05).ResultsA total of 14,061 patients from 12 studies were finally enrolled in our analysis.For the analysis of poor prognosis,Our results suggested that elevated PLR was positively associated with all-cause deaths during hospitalization(RR:2.29,95%CI:1.68-3.11,P<0.0001),but not with recurrent myocardial infarction events during hospitalization(RR:1.67,95%CI= 0.84-3.36,P = 0.15),nor with stroke events during hospitalization(RR:0.65,95%CI =0.10-4.26,P = 0.65);In long-term follow adverse outcomes,elevated PLR levels were associated with all-cause death events(RR:2.27,95%CI:1,56-3.29,P<0.0001)and recurrent myocardial infarction events(RR:1.51,95%CI:1.29-1.76,P<0.00001),but not with long-term stroke events(RR:1.18,95%CI:0.52-2.66,P = 0.69).For the angiographic and procedural characteristics,the higher PLR was also positively related to the no-reflow phenomenon(RR:2.51,95%CI:1.49-4.22),but had no significant relationship with multi-vessel disease(RR:1.06,95%CI:0.96-1.17).Conclusions1.Raised PLR is a predictive indicator of poor prognosis in patients with CAD.The incidence of all-cause death and long-term recurrent myocardial infarction in patients with high PLR increased significantly;2.platelet-lymphocyte ratio is related to the severity of coronary artery disease.High PLR often indicates that no-reflow phenomenon is more likely to occur. |
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