ArticleEuropean journal of medical research2025
Association between platelet-to-lymphocyte ratio and 28-day all-cause mortality in patients with asymptomatic coronary artery disease: a cohort study.
Article in European journal of medical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRecent evidence suggests a link between platelet-to-lymphocyte ratio (PLR) and coronary artery disease (CAD) outcomes. However, studies on asymptomatic CAD (ACAD) and short-term outcomes like 28-day mortality are limited. This research will explore the correlation between PLR and 28-day mortality in ACAD patients and assess a potential dose-response relationship.
methodsThis retrospective cohort study leverages data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. We included patients diagnosed with ACAD and collected baseline characteristics, laboratory test results, and clinical data during hospitalization. The primary endpoint was 28-day all-cause mortality. Analytical approaches included multivariable Cox proportional hazards regression models, stratified analysis, restricted cubic splines (RCS), and threshold effect analyses to evaluate the association between PLR and 28-day all-cause mortality. Given the skewed distribution of PLR values, natural logarithm (ln) transformation was applied for statistical analyses.
resultsOur study encompassed 4,563 ACAD patients, of whom 71.7% were male, with a mean age of 71.8 years. Overall, 12.8% of patients experienced 28-day mortality. Analysis revealed a J-shaped curve relationship between PLR and 28-day all-cause mortality. Threshold analysis indicated that participants with lnPLR < 4.308 had a Hazard Ratio (HR) of 0.814 for 28-day all-cause mortality (95% CI 0.627-1.057; P = 0.122), whereas those with lnPLR > 4.308 had an HR of 1.441 (95% CI 1.245-1.668; P < 0.001). Below the threshold, increasing lnPLR did not significantly correlate with changes in 28-day mortality risk. Conversely, above this threshold, each unit increase in lnPLR was associated with a 44.1% increased risk of 28-day mortality.
conclusionAmong adult patients with ACAD in the United States, there exists a J-shaped relationship between PLR and 28-day all-cause mortality. Elevated PLR levels are associated with adverse outcomes in ACAD patients.
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