E-Abstract

JACC

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TCTAP A-007

Diagnostic Accuracy of Platelet to Lymphocyte Ratio for Predicting No Slow Reflow After Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis

By Hendy Bhaskara Perdana Putra, Intan Dwistya Wiraguna, Noer Halimatus Syakdiyah, Libriansyah -, Richardus Rukma Juslim

Presenter

Hendy Bhaskara Perdana Putra

Authors

Hendy Bhaskara Perdana Putra1, Intan Dwistya Wiraguna2, Noer Halimatus Syakdiyah3, Libriansyah -1, Richardus Rukma Juslim1

Affiliation

Dr. Ramelan Navy Hospital Surabaya, Indonesia1, RS Universitas Airlangga, Indonesia2, Airlangga University, Indonesia3
View Study Report
TCTAP A-007
ACS/AMI

Diagnostic Accuracy of Platelet to Lymphocyte Ratio for Predicting No Slow Reflow After Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis

Hendy Bhaskara Perdana Putra1, Intan Dwistya Wiraguna2, Noer Halimatus Syakdiyah3, Libriansyah -1, Richardus Rukma Juslim1

Dr. Ramelan Navy Hospital Surabaya, Indonesia1, RS Universitas Airlangga, Indonesia2, Airlangga University, Indonesia3

Background

Primary Percutaneous Coronary Intervention (PCI) continues to be the primary approach for reestablishing blood flow during acute myocardial infarction (MI). Despite the successful restoration of epicardial coronary artery patency following PCI, there is a risk of No Slow Reflow (NSR) phenomenon may not be entirely averted.Several studies have shown that Platelet to Lymphocyte Ratio (PLR) may predict incidence of NSR phenomenon and associate with mortality and adverse outcomes in PCI. We performed this systematic review and meta – analysis to obtain summary estimates of the diagnostic accuracy of PLR to predict NSR phenomenon in acute MI which treated with Primary PCI.

Methods

This study was conducted according to PRISMA – DTA statement. We performed a systematic literature search from several electronic databases. Criteria inclusion were Randomized Control Trial (RCT) or observational study which reported initial PLR in patients with acute MI who undergone Primary PCI and developed NSR phenomenon. Primary outcome were summary points (pooled sensitivity and specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio), and summary lines (SROC curve). Furthermore, we also assess mean difference (MD), with 95% confidence intervals (CIs) between no NSR phenomenon and NSR phenomenon group, as a secondary outcome.

Results

Fifteen studies were selected with 6.318 patients met the inclusion criteria and were included. However only six studies had their data processed into summary points and summary lines. The pooled sensitivity of PLR for predicting NSR phenomenon in patients with acute MI who undergone Primary PCI was 0.69 (95% CI [0.56-0.79]), with specificity was 0.75 (95% CI [0.67-0.81]). The positive likelihood ratio was 2.7 (95% CI [1.9-3.9]), the negative likelihood ratio was 0.42 (95% CI [0.28-0.62]), diagnostic odds ratio was 7 (95% CI [3-13]). The area under the curve of the summary receiver operator characteristic (SROC) was 0.78 (95% CI [0.75-0.82]). The optimal cut off point was 190. Furthermore, patient with normal reflow have lower PLR level (MD= -64.59 [95% CI, -82.23;-46.95],p=0.03).


Conclusion

Patient who developed NSR after Primary PCI had higher level of PLR. And PLR might be able to play a more important role in predicting NSR phenomenon in patients with acute MI who undergone Primary PCI.