Value of the Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio in Predicting CPET Performance in Patients with Stable CAD and Recent Elective PCI

• Published in: Medicina (Kaunas, Lithuania) Lithuania), 2022-06, Vol.58 (6), p.814
• Main Authors: Drugescu, Andrei, Roca, Mihai, Zota, Ioana Mădălina, Costache, Alexandru-Dan, Gavril, Oana Irina, Gavril, Radu Sebastian, Vasilcu, Teodor Flaviu, Mitu, Ovidiu, Esanu, Irina Mihaela, Roca, Iulia-Cristina, Ghiciuc, Cristina Mihaela, Mitu, Florin
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Adult; Age; Aged; Bacterial Toxins; Biochemistry; Biomarkers; Blood platelets; Blood pressure; Blood tests; Cardiac arrhythmia; cardiopulmonary exercise test; Cardiovascular disease; Coronary Artery Disease; Cross-Sectional Studies; Diabetes; Ethics; Exercise; Exercise Test; Female; functional capacity; Heart failure; Heart rate; Hemoglobin; Hospitals; Humans; Laboratories; Lymphocyte Count; Lymphocytes; Male; Middle Aged; Mortality; neutrophil to lymphocyte ratio; Neutrophils; Normal distribution; oxygen uptake; Percutaneous Coronary Intervention - adverse effects; Physical fitness; platelet to lymphocyte ratio; Prognosis; Rehabilitation; Retrospective Studies; Review boards; Software; Stroke Volume; Thrombosis; Ventricular Function, Left
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina58060814

Background and Objectives: Functional capacity (FC) assessed via cardiopulmonary exercise testing (CPET) is a novel, independent prognostic marker for patients with coronary artery disease (CAD). Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are two readily available predictors of systemic inflammation and cardiovascular event risk, which could be used as cost-effective predictors of poor FC. The purpose of this study was to evaluate the utility of NLR and PLR in predicting poor FC in patients with CAD and recent elective percutaneous coronary intervention (PCI). Materials and Methods: Our cross-sectional retrospective analysis included 80 patients with stable CAD and recent elective PCI (mean age 55.51 ± 11.83 years, 71.3% male) who were referred to a cardiovascular rehabilitation center from January 2020 to June 2021. All patients underwent clinical examination, cardiopulmonary exercise testing on a cycle ergometer, transthoracic echocardiography and standard blood analysis. Results: Patients were classified according to percent predicted oxygen uptake (% VO2 max) in two groups—poor FC (≤70%, n = 35) and preserved FC (>70%, n = 45). There was no significant difference between groups regarding age, gender ratio, presence of associated comorbidities, left ventricular ejection fraction and NLR. PLR was higher in patients with poor FC (169.8 ± 59.3 vs. 137.4 ± 35.9, p = 0.003). A PLR cut-off point of 139 had 74% sensitivity and 60% specificity in predicting poor FC. After multivariate analysis, PLR remained a significant predictor of poor functional status. Conclusions: Although CPET is the gold standard test for assessing FC prior to cardiovascular rehabilitation, its availability remains limited. PLR, a cheap and simple test, could predict poor FC in patients with stable CAD and recent elective PCI and help prioritize referral for cardiovascular rehabilitation in high-risk patients.