| RESEARCH ARTICLE |
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| Year : 2016 | Volume
: 48
| Issue : 4 | Page : 355-359 |
Platelet-to-lymphocyte ratio but not neutrophil-to-lymphocyte ratio predicts high on-treatment platelet reactivity in clopidogrel-treated patients with acute coronary syndrome
Edem Efe1, Ibrahim Kocayigit2, Pabuccu Mustafa Turker2, Kucukukur Murat3, Alpaslan Erkan4, Tas Sedat4, Cil Alper4, Aksoy Murat Necati2, Vural Mustafa Gokhan2, Akdeniz Bahri4
1 Tınaztepe Hospital, Department of Cardiology, Sakarya University Training and Research Hospital, Sakarya, Turkey
2 Department of Cardiology, Izmir Bergama State Hospital, Izmir, Turkey
3 Department of Cardiology, Dokuz Eylül University Faculty of Medicine, Turkey
4 Department of Cardiology, Uşak State Hospital, Usak, Turkey
Correspondence Address:
Edem Efe
Tınaztepe Hospital, Department of Cardiology, Sakarya University Training and Research Hospital, Sakarya
Turkey
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0253-7613.186205
Objectives: Dual antiplatelet therapy (DAPT), consisting of clopidogrel and aspirin, is the main-stay treatment of acute coronary syndromes (ACS). However, major adverse cardiovascular events may occur even in patients undergoing DAPT, and this has been related to the variable pharmacodynamic efficacy of these drugs, especially clopidogrel. Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are novel inflammatory markers for cardiovascular risk stratification, which may reflect an inflammatory state and thus high on-treatment platelet reactivity (HPR).
Methods: We investigated the usefulness of PLR and NLR in predicting HPR in clopidogrel-treated patients with ACS. A total of 244 patients were enrolled in this study, and 43 of them were nonresponsive to clopidogrel.
Results: Logistic regression analysis indicated that PLR was significantly associated with HPR (P < 0.001). Using a cutoff level of 331, PLR predicted HPR with a sensitivity of 73% and a specificity of 69% (odds ratio: 376.15, 95% confidence interval = 37.813–3741.728 P< 0.001, receiver operating characteristic curve: 0.885).
Conclusions: We suggest that more attention should be paid to the PLR values of these patients on admission to identify individuals who may not benefit from clopidogrel during the course of ACS.
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