Observational studyBMC cardiovascular disorders2020
Preoperative neutrophil to lymphocyte ratio and platelet to lymphocyte ratio are associated with major adverse cardiovascular and cerebrovascular events in coronary heart disease patients undergoing non-cardiac surgery.
Observational study in BMC cardiovascular disorders, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02874508 (Association of Circulating Leukocyte Subpopulations and Cardio Vascular Events in the Perioperative Period), which is not on this map. Cited by 40 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Association of Circulating Leukocyte Subpopulations and Cardio Vascular Events in the Perioperative Period
Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- Lymphocyte Subsets and Cytokine Changes in Women With Gestational Diabetes Mellitus: A Systematic Review.Journal of diabetes research · 2025Pooled it
- Relationship between Platelet-to-Lymphocyte Ratio and Lymphocyte-to-Monocyte Ratio with Spontaneous Preterm Birth: A Systematic Review and Meta-analysis.Journal of immunology research · 2023Pooled it
- Machine learning-based prediction of intraoperative blood transfusion in major surgery: exploiting clinical variables and systemic inflammatory indices.Annals of medicine · 2026Article
- Machine learning in predicting preoperative intra-aortic balloon pump use in patients undergoing coronary artery bypass grafting.Journal of cardiothoracic surgery · 2025Article
- Association of Comorbidity and Inflammatory and Nutritional Markers with Epilepsy and Seizure Frequency.Nutrients · 2025Article
- Neutrophil-to-Lymphocyte Ratio as a Predictor of Mortality and Clinical Outcomes in Heart Failure Patients.Cureus · 2025Review
- Predictive Value of MHR, PLR Combined With NLRP1 for Severity and Long-Term Prognosis in Premature Coronary Artery Disease.Immunity, inflammation and disease · 2025Article
- Decoding Inflammation: The Role of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Predicting Critical Outcomes in COVID-19 Patients.Medicina (Kaunas, Lithuania) · 2025Observational
- Association between inflammatory burden index and prognosis in patients with coronary heart disease: A retrospective study.PloS one · 2025Article
- A multidimensional approach to assess cardiovascular disease risk combining biochemical, hematological, lipid ratios, atherosclerotic cardiovascular disease, and WHO/ISH 10-year risk estimators: a cross-sectional study.American journal of cardiovascular disease · 2025Article
- Relationship between inflammatory markers and long-term prognosis in ICU patients with acute non-ST-segment elevation myocardial infarction.Frontiers in cardiovascular medicine · 2025Article
- Predictive Value of Neutrophil-to-Lymphocyte Ratio for Cerebral Infarction in Obstructive Sleep Apnea: A Nomogram-Based Analysis.Nature and science of sleep · 2025Article
- Prognostic value of the platelet, neutrophil, monocyte, basophil, and eosinophil to lymphocyte ratios in patients with severe community-acquired pneumonia (SCAP).Scientific reports · 2024Article
- Inflammation indices in association with periodontitis and cancer.Periodontology 2000 · 2024Review
- Association of systemic inflammatory response index and clinical outcome in acute traumatic spinal cord injury patients.Scientific reports · 2024Article
- The Prognostic Role of the Neutrophil-to-Lymphocytes Ratio in the Most Frequent Cardiovascular Diseases: An Update.Life (Basel, Switzerland) · 2024Review
- Prediction of Osteoporotic Hip Fracture Outcome: Comparative Accuracy of 27 Immune-Inflammatory-Metabolic Markers and Related Conceptual Issues.Journal of clinical medicine · 2024Article
- Exploring Periodontal Conditions, Salivary Markers, and Systemic Inflammation in Patients with Cardiovascular Diseases.Biomedicines · 2024Article
- The Effect of Probiotics on the Prognostication of the Neutrophil-to-Lymphocyte Ratio in Severe Multi-Trauma Patients.Journal of personalized medicine · 2024Article
- Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPreoperative risk prediction in patients at elevated cardiovascular risk shows limited accuracy. Platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) indicate systemic inflammation. Both have been investigated for outcome prediction in the field of oncology and cardiovascular medicine, as well as risk prediction of adverse cardiovascular events in non-surgical patients at increased cardiovascular risk.
methodsFor this post-hoc analysis, we included all 38 coronary heart disease patients from the Leukocytes and Cardiovascular Perioperative Events cohort-1 study scheduled for elective non-cardiac surgery. We evaluated preoperative differential blood counts for association with major adverse cardiovascular and cerebrovascular events (MACCE) defined as the composite endpoint of death, myocardial ischemia, myocardial infarction, myocardial injury after non-cardiac surgery, or embolic or thrombotic stroke within 30 days after surgery. We used Youden's index to calculate cut-off values for PLR and NLR. Additive risk-predictive values were assessed using receiver operating characteristic curve and net reclassification (NRI) improvement analyses.
resultsPatients with the composite endpoint MACCE had higher PLR and NLR (309 [206; 380] vs. 160 [132; 203], p = 0.001; 4.9 [3.5; 8.1] vs. 2.6 [2.2; 3.4]), p = 0.001). Calculated cut-offs for PLR > 204.4 and NLR > 3.1 were associated with increased risk of 30-day MACCE (OR 7, 95% CI [1.2; 44.7], p = 0.034; OR 36, 95% CI [1.8; 686.6], p = 0.001). Furthermore, NLR improved risk prediction in coronary heart disease patients undergoing non-cardiac surgery when combined with hs-cTnT or NT-proBNP (NRI
conclusionsBoth PLR and NLR were associated with perioperative cardiovascular adverse events in coronary heart disease patients. NLR proved to be of additional value for preoperative risk stratification. Both PLR and NLR could be used as inexpensive and broadly available tools for perioperative risk assessment.
trial registrationNCT02874508, August 22, 2016.
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