The Association between Platelet Lymphocyte Ratio and In-Hospital Outcomes in Patients with First Attack of Acute ST-elevation Myocardial Infraction following Thrombolysis with Streptokinase in a Tertiary Care Hospital

Introduction: Platelet Lymphocyte ratio (PLR) has been found to be a good predictor of future adverse cardiovascular outcomes in patients with ST-segment elevation myocardial infarction (STEMI).

Aim: Investigation was done in the aim to detect the role of Platelet Lymphocyte ratio (PLR) in predicting in-hospital adverse cardiac events in patients with STEMI thrombolysed with streptokinase in a tertiary care hospital.

Methods: This cross sectional descriptive study carried out in the Department of Cardiology, Mymensingh Medical College Hospital, Mymensingh for fifteen-month duration from January, 2018 to March, 2019, in STEMI patients, who were thrombolysed with inj. Streptokinase (STK) had blood samples at admission, analyzed complete blood counts for PLR calculation. They were grouped into two, low and high PLR, taking 150 as cut-off. Chi square test was used to compare rate of adverse events and death in hospital stay. Logistic regression analysis was used to estimate predictive ability of PLR for in-hospital cardiac events.

Results: A total of 79 patients among 217 patients had complications. Patients in high PLR group had higher rate of complications (63.6% vs. 21.4%, p <0.001) in hospital than those in low PLR group. Arrhythmias (13.0% vs. 5.0%, p <0.036), Heart failure (45.5% vs. 15.0%, p=0.001), Cardiogenic shock (10.4% vs.3.6%, p <0.001), Death (9.1% vs. 6.4%, p=0.473), occurred more in high PLR group. Mean PLR was significantly different between Group-I and Group-II (96.21±27.79 vs. 233.21±88.20, p<0.001). Multivariate regression analysis showed PLR an independent predictor of in-hospital adverse cardiac events (at 10% level of significance, p = 0.001).

Conclusion: High admission PLR is an independent predictor for in-hospital adverse cardiac events in patients hospitalized for STEMI thrombolysed with streptokinase.