Cor Vasa 2021, 63(6):652-660 | DOI: 10.33678/cor.2021.095

Prognostic value of the combination of TIMI risk score and mean platelet volume to lymphocyte count ratio in patients with acute coronary syndrome

Emre Yilmaza, Ercan Aydinb
a Department of Cardiology, Giresun University Faculty of Medicine, Turkey
b Department of Cardiology, Vakfikebir State Hospital, Trabzon, Turkey

Background: Thrombolysis In Myocardial Infarction (TIMI) risk score and MPV/lymphocyte ratio (MPVLR) are important parameters that can be used to predict mortality and major cardiovascular adverse events (MACE) in patients with acute coronary syndrome (ACS). However, the prognostic value of a modified score system that is based on the relationships and combinations of these parameters in ACS patients is unknown. Hence, we aimed to investigate the relationship between the modified risk score obtained by the combination of TIMI risk score and MPVLR with 2-year-long MACE and mortality in ACS patients., Method: In this study, 472 consecutive patients with a diagnosis of ACS, who were revascularized using percutaneous coronary intervention, were included. The patients were evaluated in groups of two, namely MACE (+) and MACE (-), and also as "High" and "Low" according to the cut-off value of the MPVLR + TIMI modified score., Results: The area under the curve values of the modified MPVLR + TIMI for two-year MACE and mortality prediction were found to be 0.893 (0.812-0.974, p < 0.001) and 0.864 (0.715-1.00, p = 0.001), respectively, and were observed to be superior to the individual MPVLR and TIMI scores. In the Kaplan-Meier survival analysis, it was detected that the MPVLR + TIMI combination score for long-term MACE and mortality (log rank: 59.329, p <0.001 and log rank: 12.085, p = 0.001, respectively) was superior to individual MPVLR and TIMI scores. In the Cox regression analysis performed to determine long-term MACE risk factors, the MPVLR + TIMI combination score (HR: 5.41, p = 0.006) was noted to be superior to MPVLR (HR: 2.88, p = 0.094), TIMI score (HR: 2.92, p = 0.099), and other variables., Conclusion: The modified MPVLR + TIMI score was found to be superior to the MPVLR and TIMI score individually in predicting 2-year mortality and MACE in ACS patients.,

Keywords: Acute coronary syndrome, MACE, Mean platelet volume to lymphocyte ratio, Mortality, Thrombolysis In Myocardial Infarction risk score

Received: April 1, 2021; Revised: July 31, 2021; Accepted: August 3, 2021; Published: December 13, 2021  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Yilmaz E, Aydin E. Prognostic value of the combination of TIMI risk score and mean platelet volume to lymphocyte count ratio in patients with acute coronary syndrome. Cor Vasa. 2021;63(6):652-660. doi: 10.33678/cor.2021.095.
Download citation

References

  1. Sparv D, Hofmann R, Gunnarsson A, et al. DETO2X-SWEDEHEART Investigators. The Analgesic Effect of Oxygen in Suspected Acute Myocardial Infarction: A Substudy of the DETO2X-AMI Trial. JACC Cardiovasc Interv 2018;11(16):1590-1597. Go to original source... Go to PubMed...
  2. Bressi E, Mangiacapra F, Ricottini E, et al. Impact of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio on 5-Year Clinical Outcomes of Patients with Stable Coronary Artery Disease Undergoing Elective Percutaneous Coronary Intervention. J Cardiovasc Transl Res 2018;11:517-523. Go to original source... Go to PubMed...
  3. Antman EM, Cohen M, Bernink PJ, et al. The TIMI risk score for unstable angina/non-ST elevation MI: A method for prognostication and therapeutic decision making. JAMA 2000;284:835-842. Go to original source... Go to PubMed...
  4. Zhu H, Xue H, Wang H, et al. Risk stratification and prognostic value of GRACE and TIMI risk scores for female patients with non-ST segment elevation acute coronary syndrome. Int J Clin Exp Med 2015;8:4038-4044.
  5. Jakimov T, Mrdović I, Filipović B, et al. Comparison of RISK-PCI, GRACE, TIMI risk scores for prediction of major adverse cardiac events in patients with acute coronary syndrome. Croat Med J 2017;58:406-415. Go to original source... Go to PubMed...
  6. Graham CA, Chan JW, Chan CP, et al. Prospective validation of Thrombolysis in Myocardial Infarction and front door Thrombolysis in Myocardial Infarction risk scores in Chinese patients presenting to the ED with chest pain. Am J Emerg Med 2014;32:1339-1344. Go to original source... Go to PubMed...
  7. Nording HM, Seizer P, Langer HF. Platelets in inflammation and atherogenesis. Front Immunol 2015;6:98. Go to original source... Go to PubMed...
  8. May AE, Langer H, Seizer P, et al. Platelet-leukocyte interactions in inflammation and atherothrombosis. Semin Thromb Hemost 2007;33:123-127. Go to original source... Go to PubMed...
  9. Chen X, Shao M, Zhang T, et al. Prognostic value of the combination of GRACE risk score and mean platelet volume to lymphocyte count ratio in patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention. Exp Ther Med 2020;19:3664-3674. Go to original source... Go to PubMed...
  10. Ridker PM, Everett BM, Thuren T, et al. CANTOS Trial Group. Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease. N Engl J Med 2017;377:1119-1131. Go to original source... Go to PubMed...
  11. Fuentes Q E, Fuentes Q F, Andrés V, et al. Role of platelets as mediators that link inflammation and thrombosis in atherosclerosis. Platelets 2013;24:255-262. Go to original source... Go to PubMed...
  12. Sage AP, Mallat Z. Multiple potential roles for B cells in atherosclerosis. Ann Med 2014;46:297-303. Go to original source... Go to PubMed...
  13. Linden MD, Jackson DE. Platelets: pleiotropic roles in atherogenesis and atherothrombosis. Int J Biochem Cell Biol 2010;42:1762-1766. Go to original source... Go to PubMed...
  14. Chen X, Meng Y, Shao M, et al. Prognostic Value of Pre-Infarction Angina Combined with Mean Platelet Volume to Lymphocyte Count Ratio for No-Reflow and Short-Term Mortality in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention. Med Sci Monit 2020;26:e919300. Go to original source... Go to PubMed...
  15. Życzkowski M, Kaletka Z, Rajwa P, et al. Mean platelet volume-to-lymphocyte ratio: a novel biomarker associated with overall survival in patients with nonmetastatic clear cell renal cell carcinoma treated with nephrectomy. Int Urol Nephrol 2020;52:885-891. Go to original source... Go to PubMed...
  16. Kurtul A,Acikgoz SK. Usefulness of mean platelet volume-to-lymphocyte ratio for predicting angiographic no‑reflow and short‑term prognosis after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. Am J Cardiol 2017;120:534-541. Go to original source... Go to PubMed...
  17. Thompson CB, Eaton KA, Princiotta SM, et al. Size dependent platelet subpopulations: relationship of platelet volume to ultrastructure, enzymatic activity, and function. Br J Haematol 1982;50:509-519. Go to original source... Go to PubMed...
  18. Celik T, Kaya MG, Akpek M, et al. Predictive value of admission platelet volume indices for in-hospital major adverse cardiovascular events in acute ST-segment elevation myocardial infarction. Angiology 2015;66:155162. Go to original source... Go to PubMed...
  19. Kiriş T, Yazici S, Günaydin ZY, et al. The prognostic impact of in-hospital change in mean platelet volume in patients with non-ST-segment elevation myocardial infarction. Angiology 2016;67:690696. Go to original source... Go to PubMed...
  20. Núñez J, Miñana G, Bodí V, et al. Low lymphocyte count and cardiovascular diseases. Curr Med Chem 2011;18:32263233. Go to original source... Go to PubMed...
  21. Hudzik B, Szkodziński J, Lekston A, et al. Mean platelet volume-to-lymphocyte ratio: a novel marker of poor short- and long-term prognosis in patients with diabetes mellitus and acute myocardial infarction. J Diabetes Complications 2016;30:1097-1102. Go to original source... Go to PubMed...
  22. Ornek E, Kurtul A. Relationship of mean platelet volume to lymphocyte ratio and coronary collateral circulation in patients with stable angina pectoris. Coron Artery Dis 2017;28:492-497. Go to original source... Go to PubMed...
  23. Aktürk E, Aşkin L, Taşolar H, et al. Comparison of the Predictive Roles of Risk Scores of In-Hospital Major Adverse Cardiovascular Events in Patients with Non-ST Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention. Med Princ Pract 2018;27:459-465. Go to original source... Go to PubMed...
  24. Acet H, Ertaş F, Bilik MZ, et al. The relationship of TIMI risk index with SYNTAX and Gensini risk scores in predicting the extent and severity of coronary artery disease in patients with STEMI undergoing primary percutaneous coronary intervention. Ther Adv Cardiovasc Dis 2015;9:257-266. Go to original source... Go to PubMed...
  25. Kim JH, Jeong MH, Ahn Y, et al. Other Korea Acute Myocardial Infarction Registry (KAMIR) Investigators. A Novel Risk Stratification Model for Patients with Non-ST Elevation Myocardial Infarction in the Korea Acute Myocardial Infarction Registry (KAMIR): Limitation of the TIMI Risk Scoring System. Chonnam Med J 2011;47:20-26. Go to original source... Go to PubMed...
  26. Greenslade JH, Chung K, Parsonage WA, et al. Modification of the Thrombolysis in Myocardial Infarction risk score for patients presenting with chest pain to the emergency department. Emerg Med Australas 2018;30:47-54. Go to original source... Go to PubMed...

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.





Cor et Vasa

You are accessing a site intended for medical professionals, not the lay public. The site may also contain information that is intended only for persons authorized to prescribe and dispense medicinal products for human use.

I therefore confirm that I am a healthcare professional under Act 40/1995 Coll. as amended by later regulations and that I have read the definition of a healthcare professional.