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Leuko-platelet index predicts thrombotic events in patients with acute coronary syndrome
To evaluate the predictive value of a bedside index in hospitalized patients with acute coronary syndromes (ACS). We studied the association of leuko-platelet index (LPI: platelet count * leukocyte count/108) with risk of mortality, shock, or heart failure (combined end point-CEP), and with the resp...
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Published in: | International journal of cardiology 2021-04, Vol.328, p.29-34 |
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container_title | International journal of cardiology |
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description | To evaluate the predictive value of a bedside index in hospitalized patients with acute coronary syndromes (ACS).
We studied the association of leuko-platelet index (LPI: platelet count * leukocyte count/108) with risk of mortality, shock, or heart failure (combined end point-CEP), and with the response to antiplatelet therapy, measured by light transmission aggregometry.
In the derivation cohort we included 1100 patients with non STEM-ACS, GRACE score of 133 ± 52, Crusade score 24,3 ± 14, 66% male, 65 + 11 years. LPI was 17 (12–24). LPI was higher (19 (13–25)) in patients with MI than in patients with unstable angina (16 (12−22) in (p 140 (OR 8.1 (2.2–29), p = 0.02). LPI (OR 1.04 (1.004–1.07) p = 0.03) and GRACE score (OR 1.02 (1.01–1.03) p 24). Conclusions:LPI > 24 was associated to CEP (OR (1.7–5.2), p 0.01), independently of age (OR 1 (0.98–1.02), p = 0.8), and GRACE score (OR 1.01 (0.99–1.01), p 0.69), and It was associated to antiplatelet resistance (OR 1.03 (95% CI 1.00–1.06) p = 0.05).
•The accurate risk stratification of acute coronary syndromes is crucial for the selection of the treatment.•Leukocytosis and increased platelet turnover have been associated to thrombotic events in ACS patients.•Leuko-platelet index > 24 was associated to cardiovascular events in patients with ACS, adding predictive value to GRACE score.•LPI was associated to resistance to antiplatelet treatment. |
doi_str_mv | 10.1016/j.ijcard.2020.11.076 |
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We studied the association of leuko-platelet index (LPI: platelet count * leukocyte count/108) with risk of mortality, shock, or heart failure (combined end point-CEP), and with the response to antiplatelet therapy, measured by light transmission aggregometry.
In the derivation cohort we included 1100 patients with non STEM-ACS, GRACE score of 133 ± 52, Crusade score 24,3 ± 14, 66% male, 65 + 11 years. LPI was 17 (12–24). LPI was higher (19 (13–25)) in patients with MI than in patients with unstable angina (16 (12−22) in (p < 0.001)).
A total of 115 patients (10.5%) had the CEP. CEP was associated to LPI (OR 1.04 (1.002–1.08), p = 0.03), age (OR 1.01 (0.97–1.05), p = 0.62) and GRACE>140 (OR 8.1 (2.2–29), p = 0.02). LPI (OR 1.04 (1.004–1.07) p = 0.03) and GRACE score (OR 1.02 (1.01–1.03) p < 0.01) were associated to cardiovascular mortality. We confirmed these results in the validation cohort #1 (686 patients, 61 + 11 years old, 47% nonST-ACS, 53% ST-ACS, 21% had CEP) and in validation cohort #2 (218 patients, 56.8% males, 73 + 7 years old, 79% nonST-ACS, GRACE score 136 + 30) and 8.3% with CEP. We used the cutoff points of LPI obtained in the derivation cohort (>24). Conclusions:LPI > 24 was associated to CEP (OR (1.7–5.2), p 0.01), independently of age (OR 1 (0.98–1.02), p = 0.8), and GRACE score (OR 1.01 (0.99–1.01), p 0.69), and It was associated to antiplatelet resistance (OR 1.03 (95% CI 1.00–1.06) p = 0.05).
•The accurate risk stratification of acute coronary syndromes is crucial for the selection of the treatment.•Leukocytosis and increased platelet turnover have been associated to thrombotic events in ACS patients.•Leuko-platelet index > 24 was associated to cardiovascular events in patients with ACS, adding predictive value to GRACE score.•LPI was associated to resistance to antiplatelet treatment.</description><identifier>ISSN: 0167-5273</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/j.ijcard.2020.11.076</identifier><identifier>PMID: 33301835</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Coronary ; Index ; Leukocytes ; Platelets ; Prognosis ; Syndrome</subject><ispartof>International journal of cardiology, 2021-04, Vol.328, p.29-34</ispartof><rights>2020 Elsevier B.V.</rights><rights>Copyright © 2020 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-3d31da8a58e20e8ca2a9083aed095ea42696d1409696b0194ea5e919b03a005c3</citedby><cites>FETCH-LOGICAL-c362t-3d31da8a58e20e8ca2a9083aed095ea42696d1409696b0194ea5e919b03a005c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33301835$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cohen Arazi, Hernán</creatorcontrib><creatorcontrib>Chirino, Daniel</creatorcontrib><creatorcontrib>Costabel, Juan Pablo</creatorcontrib><creatorcontrib>Pulmari, Camilo A.</creatorcontrib><creatorcontrib>Hirschson Prado, Alfredo</creatorcontrib><creatorcontrib>Barba, Virginia</creatorcontrib><creatorcontrib>Agüero, Pablo</creatorcontrib><creatorcontrib>Badimon, Juan José</creatorcontrib><title>Leuko-platelet index predicts thrombotic events in patients with acute coronary syndrome</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description>To evaluate the predictive value of a bedside index in hospitalized patients with acute coronary syndromes (ACS).
We studied the association of leuko-platelet index (LPI: platelet count * leukocyte count/108) with risk of mortality, shock, or heart failure (combined end point-CEP), and with the response to antiplatelet therapy, measured by light transmission aggregometry.
In the derivation cohort we included 1100 patients with non STEM-ACS, GRACE score of 133 ± 52, Crusade score 24,3 ± 14, 66% male, 65 + 11 years. LPI was 17 (12–24). LPI was higher (19 (13–25)) in patients with MI than in patients with unstable angina (16 (12−22) in (p < 0.001)).
A total of 115 patients (10.5%) had the CEP. CEP was associated to LPI (OR 1.04 (1.002–1.08), p = 0.03), age (OR 1.01 (0.97–1.05), p = 0.62) and GRACE>140 (OR 8.1 (2.2–29), p = 0.02). LPI (OR 1.04 (1.004–1.07) p = 0.03) and GRACE score (OR 1.02 (1.01–1.03) p < 0.01) were associated to cardiovascular mortality. We confirmed these results in the validation cohort #1 (686 patients, 61 + 11 years old, 47% nonST-ACS, 53% ST-ACS, 21% had CEP) and in validation cohort #2 (218 patients, 56.8% males, 73 + 7 years old, 79% nonST-ACS, GRACE score 136 + 30) and 8.3% with CEP. We used the cutoff points of LPI obtained in the derivation cohort (>24). Conclusions:LPI > 24 was associated to CEP (OR (1.7–5.2), p 0.01), independently of age (OR 1 (0.98–1.02), p = 0.8), and GRACE score (OR 1.01 (0.99–1.01), p 0.69), and It was associated to antiplatelet resistance (OR 1.03 (95% CI 1.00–1.06) p = 0.05).
•The accurate risk stratification of acute coronary syndromes is crucial for the selection of the treatment.•Leukocytosis and increased platelet turnover have been associated to thrombotic events in ACS patients.•Leuko-platelet index > 24 was associated to cardiovascular events in patients with ACS, adding predictive value to GRACE score.•LPI was associated to resistance to antiplatelet treatment.</description><subject>Coronary</subject><subject>Index</subject><subject>Leukocytes</subject><subject>Platelets</subject><subject>Prognosis</subject><subject>Syndrome</subject><issn>0167-5273</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kMlKBDEQhoMoOi5vINJHLz1Wll5yEUTcYMCLgreQSWowY0-nTdIub2_GUY-eqii-vyr5CDmmMKVA67Pl1C2NDnbKgOURnUJTb5EJbRtR0qYS22SSsaasWMP3yH6MSwAQUra7ZI9zDrTl1YQ8zXB88eXQ6YQdpsL1Fj-KIaB1JsUiPQe_mvvkTIFv2OeJ64tBJ_fdv7v0XGgzJiyMD77X4bOIn73NGTwkOwvdRTz6qQfk8frq4fK2nN3f3F1ezErDa5ZKbjm1utVViwywNZppCS3XaEFWqAWrZW2pAJnrHKgUqCuUVM6Ba4DK8ANyutk7BP86Ykxq5aLBrtM9-jEqJhougGUhGRUb1AQfY8CFGoJb5UcrCmrtVC3VxqlaO1WUquw0x05-LozzFdq_0K_EDJxvAMz_fHMYVDRZkMkOA5qkrHf_X_gCGSyKjg</recordid><startdate>20210401</startdate><enddate>20210401</enddate><creator>Cohen Arazi, Hernán</creator><creator>Chirino, Daniel</creator><creator>Costabel, Juan Pablo</creator><creator>Pulmari, Camilo A.</creator><creator>Hirschson Prado, Alfredo</creator><creator>Barba, Virginia</creator><creator>Agüero, Pablo</creator><creator>Badimon, Juan José</creator><general>Elsevier B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20210401</creationdate><title>Leuko-platelet index predicts thrombotic events in patients with acute coronary syndrome</title><author>Cohen Arazi, Hernán ; Chirino, Daniel ; Costabel, Juan Pablo ; Pulmari, Camilo A. ; Hirschson Prado, Alfredo ; Barba, Virginia ; Agüero, Pablo ; Badimon, Juan José</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-3d31da8a58e20e8ca2a9083aed095ea42696d1409696b0194ea5e919b03a005c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Coronary</topic><topic>Index</topic><topic>Leukocytes</topic><topic>Platelets</topic><topic>Prognosis</topic><topic>Syndrome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cohen Arazi, Hernán</creatorcontrib><creatorcontrib>Chirino, Daniel</creatorcontrib><creatorcontrib>Costabel, Juan Pablo</creatorcontrib><creatorcontrib>Pulmari, Camilo A.</creatorcontrib><creatorcontrib>Hirschson Prado, Alfredo</creatorcontrib><creatorcontrib>Barba, Virginia</creatorcontrib><creatorcontrib>Agüero, Pablo</creatorcontrib><creatorcontrib>Badimon, Juan José</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cohen Arazi, Hernán</au><au>Chirino, Daniel</au><au>Costabel, Juan Pablo</au><au>Pulmari, Camilo A.</au><au>Hirschson Prado, Alfredo</au><au>Barba, Virginia</au><au>Agüero, Pablo</au><au>Badimon, Juan José</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Leuko-platelet index predicts thrombotic events in patients with acute coronary syndrome</atitle><jtitle>International journal of cardiology</jtitle><addtitle>Int J Cardiol</addtitle><date>2021-04-01</date><risdate>2021</risdate><volume>328</volume><spage>29</spage><epage>34</epage><pages>29-34</pages><issn>0167-5273</issn><eissn>1874-1754</eissn><abstract>To evaluate the predictive value of a bedside index in hospitalized patients with acute coronary syndromes (ACS).
We studied the association of leuko-platelet index (LPI: platelet count * leukocyte count/108) with risk of mortality, shock, or heart failure (combined end point-CEP), and with the response to antiplatelet therapy, measured by light transmission aggregometry.
In the derivation cohort we included 1100 patients with non STEM-ACS, GRACE score of 133 ± 52, Crusade score 24,3 ± 14, 66% male, 65 + 11 years. LPI was 17 (12–24). LPI was higher (19 (13–25)) in patients with MI than in patients with unstable angina (16 (12−22) in (p < 0.001)).
A total of 115 patients (10.5%) had the CEP. CEP was associated to LPI (OR 1.04 (1.002–1.08), p = 0.03), age (OR 1.01 (0.97–1.05), p = 0.62) and GRACE>140 (OR 8.1 (2.2–29), p = 0.02). LPI (OR 1.04 (1.004–1.07) p = 0.03) and GRACE score (OR 1.02 (1.01–1.03) p < 0.01) were associated to cardiovascular mortality. We confirmed these results in the validation cohort #1 (686 patients, 61 + 11 years old, 47% nonST-ACS, 53% ST-ACS, 21% had CEP) and in validation cohort #2 (218 patients, 56.8% males, 73 + 7 years old, 79% nonST-ACS, GRACE score 136 + 30) and 8.3% with CEP. We used the cutoff points of LPI obtained in the derivation cohort (>24). Conclusions:LPI > 24 was associated to CEP (OR (1.7–5.2), p 0.01), independently of age (OR 1 (0.98–1.02), p = 0.8), and GRACE score (OR 1.01 (0.99–1.01), p 0.69), and It was associated to antiplatelet resistance (OR 1.03 (95% CI 1.00–1.06) p = 0.05).
•The accurate risk stratification of acute coronary syndromes is crucial for the selection of the treatment.•Leukocytosis and increased platelet turnover have been associated to thrombotic events in ACS patients.•Leuko-platelet index > 24 was associated to cardiovascular events in patients with ACS, adding predictive value to GRACE score.•LPI was associated to resistance to antiplatelet treatment.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>33301835</pmid><doi>10.1016/j.ijcard.2020.11.076</doi><tpages>6</tpages></addata></record> |
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title | Leuko-platelet index predicts thrombotic events in patients with acute coronary syndrome |
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