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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
Main Authors: Cohen Arazi, Hernán, Chirino, Daniel, Costabel, Juan Pablo, Pulmari, Camilo A., Hirschson Prado, Alfredo, Barba, Virginia, Agüero, Pablo, Badimon, Juan José
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container_title International journal of cardiology
container_volume 328
creator Cohen Arazi, Hernán
Chirino, Daniel
Costabel, Juan Pablo
Pulmari, Camilo A.
Hirschson Prado, Alfredo
Barba, Virginia
Agüero, Pablo
Badimon, Juan José
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 &lt; 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&gt;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 &lt; 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 (&gt;24). Conclusions:LPI &gt; 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 &gt; 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. 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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 &lt; 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&gt;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 &lt; 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 (&gt;24). Conclusions:LPI &gt; 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 &gt; 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 &lt; 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&gt;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 &lt; 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 (&gt;24). Conclusions:LPI &gt; 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 &gt; 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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subjects Coronary
Index
Leukocytes
Platelets
Prognosis
Syndrome
title Leuko-platelet index predicts thrombotic events in patients with acute coronary syndrome
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