نقش نسبت پلاکت به لنفوسیت در پیش‌آگهی بیماران مبتلا به سندرم حاد کرونری: مرور نظام مند و متاآنالیز

نوع مقاله: مقاله مروری

نویسندگان

1 دانشجوی پزشکی، کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

2 استادیار گروه قلب و عروق، بیمارستان امام رضا (ع)، دانشگاه علوم پزشکی مشهد، مشهد، ایران

چکیده

مقدمه
بیماری عروق کرونر (ACS) یکی از مهم‌ترین علل مرگ و میر در جهان است و شناسایی عوامل تعیین‌کننده خطر مرگ و میر این بیماران اهمیت بسیاری دارد. هدف این مرور سیستماتیک بررسی نقش نسبت پلاکت به لنفوسیت (PLR) در تعیین پیش‌آگهی بیماران مبتلا به ACS است.
روش کار
پایگاه‌های داده PubMed، Embase و Web of Knowledge در تاریخ 29 دسامبر 2018 برای یافتن مطالعات مرتبط جستجو شدند. مطالعاتی که ارتباط PLR را با میزان مرگ و میر بیماران ACS بررسی کرده بودند وارد مرور سیستماتیک شدند. استخراج داده‌ها و بررسی کیفیت مقالات به طور مستقل توسط دو نویسنده انجام شد. متاآنالیز بر روی نسبت‌های خطر و نتایج روش‎های آماری تشخیصی انجام شد.
نتایج
سیزده مطالعه شامل 17111 بیمار وارد مرور سیستماتیک شدند. در تمام مطالعات به جز یک مورد ارتباط معنادار میان PLR و میزان مرگ و میر مشاهده شد. میزان ضریب خطر ادغام شده وقوع مرگ و میر کوتاه‌مدت و بلندمدت در گروه PLR بالا در مقایسه با گروه PLR پایین به ترتیب 187/2 (فاصله اطمینان 95%: 56/1 – 06/3) و 40/2 (فاصله اطمینان 95%: 69/1 – 42/3) بود. همچنین PLR با سطح زیرمنحنی SROC 710/0 برای مرگ و میر کوتاه‌مدت و 668/0 برای مرگ و میر بلندمدت توانایی متوسطی در تعیین پیش‌آگهی نشان داد.
نتیجه­گیری
PLR به صورت معنادار با مرگ و میر بیماران ACS مرتبط است و می‌تواند به تنهایی یا در تلفیق با سایر مارکرهای پیش‌آگهی و همچنین سیستم‌های امتیازدهی در تفکیک ریسک خطر این بیماران استفاده شود.

کلیدواژه‌ها


عنوان مقاله [English]

The prognostic value of platelet-to-lymphocyte ratio in patients with acute coronary syndrome: a systematic review and meta-analysis

نویسندگان [English]

  • Amin Saberi 1
  • Moniba Bijari 1
  • Ali Eshraghi 2
1 Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
2 Assistant Professor, Department of Cardiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
چکیده [English]

Introduction: Acute coronary syndrome (ACS) is an important cause of death. It is important to identify factors predicting mortality of these patients. The aim of this systematic review was to evaluate the prognostic role of platelet-to-lymphocyte ratio (PLR) in patients with ACS.
Materials and Methods: PubMed, Embase and Web of Knowledge databases were searched for relevant studies in, December 29th 2018. Studies investigating the association of PLR with mortality of ACS patients were included in the systematic review. Data extraction and quality assessment are performed independently by two authors. Meta-analysis of hazard ratios and the results of diagnostic statistical methods was performed.
Results: A total of Thirteen studies with 17111 participants were included in the systematic review. Significant association between PLR and mortality rate was observed in all but one study. The pooled hazard ratios of short-term and long-term mortality in high PLR group compared to low PLR group were 2.187 (CI95%: 1.56-3.06) and 2.40 (CI95%: 1.69-3.42), respectively. Moreover, PLR showed a moderate prognostic accuracy for short-term and long-term mortality with area under the SROC curves of 0.710 and 0.668, respectively.
Conclusion: PLR is significantly associated with mortality in ACS patients and can be used alone or in combination with other prognostic markers and scoring systems to stratify the risk of these patients.

کلیدواژه‌ها [English]

  • Acute coronary syndrome
  • Platelet-to-lymphocyte ratio
  • Prognosis
  • Systematic review
  • Meta-analysis

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