open access
Is platelet to monocyte ratio a useful inflammatory determinant of ST-elevation myocardial infarction?
, 2
Affiliations- Department of Emergency Department, Yozgat Bozok University Faculty of Medicine, Yozgat, Turkey
- Department of Emergency Medicine, Faculty of Medicine, Cumhuriyet University, Sivas, Türkiye
open access
Abstract
INTRODUCTION: The main factors in the development of ST-segment elevation myocardial infarction (STEMI) are inflammatory processes and pathophysiological changes due to oxidant stress. The aim of this study is to evaluate the association of prevalent STEMI with markers of inflammatory and oxidative stress. The platelet to monocyte ratio (PMR) was evaluated as a new hematological inflammatory marker.
MATERIAL AND METHODS: The study is a retrospective observational study conducted in the emergency department between January 2018 and January 2019. In the study, all patients who were diagnosed with STEMI were considered in the study group. Evaluations of inflammatory and oxidant stress markers, PMR value of STEMI patients were performed.
RESULTS: Neutrophil to lymphocyte ratio (NLR) value of 5.63 (3.35–7.84), Monocyte count to high-density lipoprotein cholesterol ratio (MHR) value of 16.10 (12.73–19.52), gamma-glutamyl transferase (GGT) value of 31.00 (21–39) and CRP value of 5.10 (2.77–9.34) were significantly higher in STEMI cases (p < 0.005). The lymphocyte to monocyte ratio (LMR) value of 2.57 (2.00–3.61) and the PMR value of 24.52 ± 7.60 in STEMI cases were significantly lower (p < 0.001, p = 0.014).
CONCLUSIONS: In STEMI patients NLR, GGT, and MHR rates increase significantly and LMR decreases. PMR values were also lower in STEMI cases. This shows us that PMR is a new determinant that can be used in inflammatory events. However, none of these inflammatory markers and oxidant stress markers can be used as diagnostic tests, rather they should be considered as surrogate markers for disease.
Abstract
INTRODUCTION: The main factors in the development of ST-segment elevation myocardial infarction (STEMI) are inflammatory processes and pathophysiological changes due to oxidant stress. The aim of this study is to evaluate the association of prevalent STEMI with markers of inflammatory and oxidative stress. The platelet to monocyte ratio (PMR) was evaluated as a new hematological inflammatory marker.
MATERIAL AND METHODS: The study is a retrospective observational study conducted in the emergency department between January 2018 and January 2019. In the study, all patients who were diagnosed with STEMI were considered in the study group. Evaluations of inflammatory and oxidant stress markers, PMR value of STEMI patients were performed.
RESULTS: Neutrophil to lymphocyte ratio (NLR) value of 5.63 (3.35–7.84), Monocyte count to high-density lipoprotein cholesterol ratio (MHR) value of 16.10 (12.73–19.52), gamma-glutamyl transferase (GGT) value of 31.00 (21–39) and CRP value of 5.10 (2.77–9.34) were significantly higher in STEMI cases (p < 0.005). The lymphocyte to monocyte ratio (LMR) value of 2.57 (2.00–3.61) and the PMR value of 24.52 ± 7.60 in STEMI cases were significantly lower (p < 0.001, p = 0.014).
CONCLUSIONS: In STEMI patients NLR, GGT, and MHR rates increase significantly and LMR decreases. PMR values were also lower in STEMI cases. This shows us that PMR is a new determinant that can be used in inflammatory events. However, none of these inflammatory markers and oxidant stress markers can be used as diagnostic tests, rather they should be considered as surrogate markers for disease.
Keywords
STEMI, NLR, LMR, PMR, inflammation, oxidative stress
About this articleTitle
Is platelet to monocyte ratio a useful inflammatory determinant of ST-elevation myocardial infarction?
Journal
Disaster and Emergency Medicine Journal
Issue
Article type
Research paper
Pages
205-211
Published online
2020-11-24
Page views
664
Article views/downloads
575
DOI
Bibliographic record
Disaster Emerg Med J 2020;5(4):205-211.
Keywords
STEMI
NLR
LMR
PMR
inflammation
oxidative stress
Authors
İbrahim Çaltekin
Erdal Demirtaş
References (24)- Choudhury T, West NEj, El-Omar M. ST elevation myocardial infarction. Clin Med (Lond). 2016; 16(3): 277–282.
- Afari ME, Bhat T. Neutrophil to lymphocyte ratio (NLR) and cardiovascular diseases: an update. Expert Rev Cardiovasc Ther. 2016; 14(5): 573–577.
- Heitzer T, Schlinzig T, Krohn K, et al. Endothelial dysfunction, oxidative stress, and risk of cardiovascular events in patients with coronary artery disease. Circulation. 2001; 104(22): 2673–2678.
- Gunes H, Saritas A, Cangur S, et al. Complete Blood Count Parameters for Prediction of non-ST Segment Elevation Myocardial Infarction. J Coll Physicians Surg Pak. 2019; 29(8): 710–714.
- Kiris T, Çelik A, Variş E, et al. Association of Lymphocyte-to-Monocyte Ratio With the Mortality in Patients With ST-Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention. Angiology. 2017; 68(8): 707–715.
- Gul M, Uyarel H, Ergelen M, et al. The relationship between γ-glutamyl transferase levels and the clinical outcomes in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Coron Artery Dis. 2013; 24(4): 272–278.
- Arısoy A, Altunkaş F, Karaman K, et al. Association of the Monocyte to HDL Cholesterol Ratio With Thrombus Burden in Patients With ST-Segment Elevation Myocardial Infarction. Clin Appl Thromb Hemost. 2017; 23(8): 992–997.
- Açıkgöz SK, Açıkgöz E, Şensoy B, et al. Monocyte to high-density lipoprotein cholesterol ratio is predictive of in-hospital and five-year mortality in ST-segment elevation myocardial infarction. Cardiol J. 2016; 23(5): 505–512.
- Lee SM, Russell A, Hellawell G. Predictive value of pretreatment inflammation-based prognostic scores (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio) for invasive bladder carcinoma. Korean J Urol. 2015; 56(11): 749–755.
- Azab B, Shah N, Akerman M, et al. Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-ST-elevation myocardial infarction. J Thromb Thrombolysis. 2012; 34(3): 326–334.
- Akpek M, Kaya MG, Lam YY, et al. Relation of neutrophil/lymphocyte ratio to coronary flow to in-hospital major adverse cardiac events in patients with ST-elevated myocardial infarction undergoing primary coronary intervention. Am J Cardiol. 2012; 110(5): 621–627.
- Yayla Ç, Akboğa MK, Gayretli Yayla K, et al. A novel marker of inflammation in patients with slow coronary flow: lymphocyte-to-monocyte ratio. Biomark Med. 2016; 10(5): 485–493.
- Stotz M, Pichler M, Absenger G, et al. The preoperative lymphocyte to monocyte ratio predicts clinical outcome in patients with stage III colon cancer. Br J Cancer. 2014; 110(2): 435–440.
- Merekoulias G, Alexopoulos EC, Belezos T, et al. Lymphocyte to monocyte ratio as a screening tool for influenza. PLoS Curr. 2010; 2: RRN1154.
- Stach K, Karb S, Akin I, et al. Elevation of Platelet and Monocyte Activity Markers of Atherosclerosis in Haemodialysis Patients Compared to Peritoneal Dialysis Patients. Mediators Inflamm. 2017; 2017: 8506072.
- Aleva FE, Temba G, de Mast Q, et al. Increased Platelet-Monocyte Interaction in Stable COPD in the Absence of Platelet Hyper-Reactivity. Respiration. 2018; 95(1): 35–43.
- Khode V, Sindhur J, Kanbur D, et al. Mean platelet volume and other platelet volume indices in patients with stable coronary artery disease and acute myocardial infarction: A case control study. J Cardiovasc Dis Res. 2012; 3(4): 272–275.
- Jiang S, Jiang D, Tao Y. Role of gamma-glutamyltransferase in cardiovascular diseases. Exp Clin Cardiol. 2013;18(1):53-6. PMID: 24294039; PMCID. : PMC3716505.
- Kim JG, Chang K, Choo EHo, et al. Serum gamma-glutamyl transferase is a predictor of mortality in patients with acute myocardial infarction. Medicine (Baltimore). 2018; 97(29): e11393.
- Emdin M, Passino C, Michelassi C, et al. Prognostic value of serum gamma-glutamyl transferase activity after myocardial infarction. Eur Heart J. 2001; 22(19): 1802–1807.
- Valjevac A, Rebic D, Hamzic-Mehmedbasic A, et al. The value of gamma glutamyltransferase in predicting myocardial infarction in patients with acute coronary syndrome. Future Cardiol. 2018; 14(1): 37–45.
- Ley K, Miller YI, Hedrick CC. Monocyte and macrophage dynamics during atherogenesis. Arterioscler Thromb Vasc Biol. 2011; 31(7): 1506–1516.
- Vahit D, Akboga MK, Samet Y, et al. Assessment of monocyte to high density lipoprotein cholesterol ratio and lymphocyte-to-monocyte ratio in patients with metabolic syndrome. Biomark Med. 2017; 11(7): 535–540.
- Escolà-Gil JC, Rotllan N, Julve J, et al. In vivo macrophage-specific RCT and antioxidant and antiinflammatory HDL activity measurements: New tools for predicting HDL atheroprotection. Atherosclerosis. 2009; 206(2): 321–327.