Platelet-to-Lymphocyte Ratio as Marker of Platelet Activation in Patients on Potent P2Y Inhibitors
A high platelet-to-lymphocyte ratio (PLR) has recently been associated with ischemic outcomes in cardiovascular disease. Increased platelet reactivity and leukocyte-platelet aggregate formation are directly involved in the progress of atherosclerosis and have been linked to ischemic events following...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-04-01
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| Series: | Journal of Cardiovascular Pharmacology and Therapeutics |
| Online Access: | https://doi.org/10.1177/10742484221096524 |
| _version_ | 1818009715466043392 |
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| author | Patricia P. Wadowski MD, PhD Joseph Pultar Constantin Weikert Beate Eichelberger Maximilian Tscharre MD, PhD Renate Koppensteiner MD Simon Panzer MD Thomas Gremmel MD, MBA |
| author_facet | Patricia P. Wadowski MD, PhD Joseph Pultar Constantin Weikert Beate Eichelberger Maximilian Tscharre MD, PhD Renate Koppensteiner MD Simon Panzer MD Thomas Gremmel MD, MBA |
| author_sort | Patricia P. Wadowski MD, PhD |
| collection | DOAJ |
| description | A high platelet-to-lymphocyte ratio (PLR) has recently been associated with ischemic outcomes in cardiovascular disease. Increased platelet reactivity and leukocyte-platelet aggregate formation are directly involved in the progress of atherosclerosis and have been linked to ischemic events following percutaneous coronary intervention (PCI). In order to understand the relation of PLR with platelet reactivity, we assessed PLR as well as agonist-inducible platelet aggregation and neutrophil-platelet aggregate (NPA) formation in 182 acute coronary syndrome (ACS) patients on dual antiplatelet therapy with aspirin and prasugrel (n = 96) or ticagrelor (n = 86) 3 days after PCI. PLR was calculated from the blood count. Platelet aggregation was measured by multiple electrode aggregometry and NPA formation was determined by flow cytometry, both in response to ADP and SFLLRN. A PLR ≥91 was considered as high PLR based on previous data showing an association of this threshold with adverse ischemic outcomes. In the overall cohort and in prasugrel-treated patients, high PLR was associated with higher SFLLRN-inducible platelet aggregation (67 AU [50-85 AU] vs 59.5 AU [44.3-71.3 AU], P = .01, and 73 AU [50-85 AU] vs 61.5 AU [46-69 AU], P = .02, respectively). Further, prasugrel-treated patients with high PLR exhibited higher ADP- (15% [11%-23%] vs 10.9% [7.6%-15.9%], P = .007) and SFLLRN-inducible NPA formation (64.3% [55.4%-73.8%] vs 53.8% [44.1%-70.1%], P = .01) as compared to patients with low PLR. These differences were not seen in ticagrelor-treated patients. In conclusion, high PLR is associated with increased on-treatment platelet reactivity in prasugrel-treated patients, but not in patients on ticagrelor. |
| first_indexed | 2024-04-14T05:46:20Z |
| format | Article |
| id | doaj.art-05d311e8b24c4a8dbb0ab40e2ee2ed70 |
| institution | Directory Open Access Journal |
| issn | 1940-4034 |
| language | English |
| last_indexed | 2024-04-14T05:46:20Z |
| publishDate | 2022-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Cardiovascular Pharmacology and Therapeutics |
| spelling | doaj.art-05d311e8b24c4a8dbb0ab40e2ee2ed702022-12-22T02:09:17ZengSAGE PublishingJournal of Cardiovascular Pharmacology and Therapeutics1940-40342022-04-012710.1177/10742484221096524Platelet-to-Lymphocyte Ratio as Marker of Platelet Activation in Patients on Potent P2Y InhibitorsPatricia P. Wadowski MD, PhD0Joseph Pultar1Constantin Weikert2Beate Eichelberger3Maximilian Tscharre MD, PhD4Renate Koppensteiner MD5Simon Panzer MD6Thomas Gremmel MD, MBA7 Department of Internal Medicine II, , Vienna, Austria Department of Internal Medicine II, , Vienna, Austria Department of Internal Medicine II, , Vienna, Austria Department of Blood Group Serology and Transfusion Medicine, , Vienna, Austria Department of Internal Medicine, Cardiology and Nephrology, Landesklinikum Wiener Neustadt, Wiener Neustadt, Austria Department of Internal Medicine II, , Vienna, Austria Department of Blood Group Serology and Transfusion Medicine, , Vienna, Austria Institute of Antithrombotic Therapy in Cardiovascular Disease, Karl Landsteiner Society, St. Pölten, AustriaA high platelet-to-lymphocyte ratio (PLR) has recently been associated with ischemic outcomes in cardiovascular disease. Increased platelet reactivity and leukocyte-platelet aggregate formation are directly involved in the progress of atherosclerosis and have been linked to ischemic events following percutaneous coronary intervention (PCI). In order to understand the relation of PLR with platelet reactivity, we assessed PLR as well as agonist-inducible platelet aggregation and neutrophil-platelet aggregate (NPA) formation in 182 acute coronary syndrome (ACS) patients on dual antiplatelet therapy with aspirin and prasugrel (n = 96) or ticagrelor (n = 86) 3 days after PCI. PLR was calculated from the blood count. Platelet aggregation was measured by multiple electrode aggregometry and NPA formation was determined by flow cytometry, both in response to ADP and SFLLRN. A PLR ≥91 was considered as high PLR based on previous data showing an association of this threshold with adverse ischemic outcomes. In the overall cohort and in prasugrel-treated patients, high PLR was associated with higher SFLLRN-inducible platelet aggregation (67 AU [50-85 AU] vs 59.5 AU [44.3-71.3 AU], P = .01, and 73 AU [50-85 AU] vs 61.5 AU [46-69 AU], P = .02, respectively). Further, prasugrel-treated patients with high PLR exhibited higher ADP- (15% [11%-23%] vs 10.9% [7.6%-15.9%], P = .007) and SFLLRN-inducible NPA formation (64.3% [55.4%-73.8%] vs 53.8% [44.1%-70.1%], P = .01) as compared to patients with low PLR. These differences were not seen in ticagrelor-treated patients. In conclusion, high PLR is associated with increased on-treatment platelet reactivity in prasugrel-treated patients, but not in patients on ticagrelor.https://doi.org/10.1177/10742484221096524 |
| spellingShingle | Patricia P. Wadowski MD, PhD Joseph Pultar Constantin Weikert Beate Eichelberger Maximilian Tscharre MD, PhD Renate Koppensteiner MD Simon Panzer MD Thomas Gremmel MD, MBA Platelet-to-Lymphocyte Ratio as Marker of Platelet Activation in Patients on Potent P2Y Inhibitors Journal of Cardiovascular Pharmacology and Therapeutics |
| title | Platelet-to-Lymphocyte Ratio as Marker of Platelet Activation in Patients on Potent P2Y Inhibitors |
| title_full | Platelet-to-Lymphocyte Ratio as Marker of Platelet Activation in Patients on Potent P2Y Inhibitors |
| title_fullStr | Platelet-to-Lymphocyte Ratio as Marker of Platelet Activation in Patients on Potent P2Y Inhibitors |
| title_full_unstemmed | Platelet-to-Lymphocyte Ratio as Marker of Platelet Activation in Patients on Potent P2Y Inhibitors |
| title_short | Platelet-to-Lymphocyte Ratio as Marker of Platelet Activation in Patients on Potent P2Y Inhibitors |
| title_sort | platelet to lymphocyte ratio as marker of platelet activation in patients on potent p2y inhibitors |
| url | https://doi.org/10.1177/10742484221096524 |
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