The neutrophil-lymphocyte ratio and platelet-lymphocyte ratio predict left ventricular thrombus resolution in acute myocardial infarction without percutaneous coronary intervention. Issue 194 (October 2020)

• Record Type: Journal Article
• Authors: Sia, Ching-Hui; Leow, Aloysius Sheng-Ting; Tan, Benjamin Yong-Qiang; Low, Christopher Junyan; Kaur, Rajinderdeep; Yeo, Tiong-Cheng; Chan, Mark Yan-Yee; Tay, Edgar Lik-Wui; Yeo, Leonard Leong-Litt; Yap, Eng-Soo; Loh, Joshua Ping-Yun
• Is Part Of: Thrombosis research. Issue 194(2020)
• Page Start: 16
• Page End: 20
• Publication Date: 2020-10
• Subjects: Acute myocardial infarction -- Left ventricular thrombus -- Neutrophil-lymphocyte ratio -- Percutaneous coronary intervention -- Platelet-lymphocyte ratio -- Thrombus resolution; Thrombosis -- Periodicals; 616.135
• DOI: 10.1016/j.thromres.2020.06.003
• Languages: English
• ISSNs: 0049-3848

Abstract

Abstract: Background: Left ventricular thrombosis (LVT) is a potentially devastating complication in post-acute myocardial infarction (AMI) patients. Previous studies have demonstrated that inflammation may contribute to thrombus formation, but its role on thrombus resolution is uncertain. The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are easily accessible haematological markers of inflammation. Objectives: We aimed to identify differences between post-AMI LVT patients with and without LVT resolution, and to evaluate the utility of NLR and PLR in predicting LVT resolution. Methods: We included 289 consecutive post-AMI patients with LVT. Acute LVT was diagnosed based on echocardiogram. Patients were stratified based on LVT resolution. Logistic regression was performed to evaluate for independent predictors of thrombus resolution. Results: Compared to post-AMI patients with eventual LVT resolution, those with unresolved LVT had more co-morbidities such as hypertension ( p = 0.003) and ischaemic heart disease ( p < 0.001), fewer underwent percutaneous coronary intervention (PCI) ( p < 0.001) or were treated with triple therapy ( p < 0.001). NLR ( p = 0.064) and PLR ( p = 0.028) were higher in unresolved LVT patients. In non-PCI patients, NLR (OR 0.818, 95% CI 0.674–0.994, p = 0.043) and PLR (OR 0.989, 95% CI 0.979–0.999, p = 0.026) were independent predictors of thrombus resolution after adjustment for age and anticoagulation use. Conclusions: Post-AMI patients not receiving PCI may have a greater inflammatory response and a higher NLR and PLR, which is associated with less LVT resolution despite anticoagulation. Further studies are required to study this association. Highlights: The role of inflammation on left ventricular thrombus (LVT) resolution is uncertain. NLR and PLR were higher in unresolved LVT. Lower NLR and PLR were associated with LVT resolution in post-AMI non-PCI patients. Post-AMI patients not receiving PCI may have a greater inflammatory response and a higher NLR and PLR.