1. Leuko-platelet index predicts thrombotic events in patients with acute coronary syndrome
- Author
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Pablo Agüero, Juan J. Badimon, Camilo A. Pulmari, Hernán Cohen Arazi, Virginia Barba, Daniel Chirino, Juan Pablo Costabel, and Alfredo Hirschson Prado
- Subjects
Blood Platelets ,Male ,Acute coronary syndrome ,medicine.medical_specialty ,Hospitalized patients ,030204 cardiovascular system & hematology ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Risk of mortality ,Medicine ,Humans ,Platelet ,In patient ,030212 general & internal medicine ,Angina, Unstable ,Acute Coronary Syndrome ,Aged ,Aged, 80 and over ,Heart Failure ,business.industry ,Unstable angina ,Thrombosis ,Middle Aged ,medicine.disease ,Prognosis ,Predictive value ,Heart failure ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - 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/10In 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 GRACE140 (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).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).
- Published
- 2020