JACC. CardioOncology (Dec 2019)

Predictive Value of the Platelet-to-Lymphocyte Ratio in Cancer Patients Undergoing Transcatheter Aortic Valve Replacement

  • Noriaki Tabata, MD,
  • Baravan Al-Kassou, MD,
  • Atsushi Sugiura, MD,
  • Jasmin Shamekhi, MD,
  • Hendrik Treede, MD,
  • Masanobu Ishii, MD, MPH,
  • Kenichi Tsujita, MD,
  • Nikos Werner, MD,
  • Eberhard Grube, MD,
  • Georg Nickenig, MD,
  • Jan-Malte Sinning, MD

Journal volume & issue
Vol. 1, no. 2
pp. 159 – 169

Abstract

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Objectives: The purpose of this study is to investigate the predictive value of the platelet-to-lymphocyte ratio (PLR)in cancer patients undergoing transcatheter aortic valve replacement (TAVR). Background: The PLR is a promising marker to predict clinical outcomes in various cancer types as well as in cardiovascular disease. Methods: Consecutive TAVR patients were enrolled in the study. We stratified patients into 2 groups: cancer and noncancer. Baseline complete blood counts with a differential hemogram were collected before TAVR. The primary outcome was all-cause death within a 3-year follow-up. Results: In total, 240 of 1,204 patients (19.9%) had a cancer history. Cancer patients had a significantly higher baseline PLR than noncancer patients (median [interquartile range], 159.8 [109.6 to 244.6] vs. 150.3 [108.7 to 209.0]; p = 0.024). Kaplan-Meier analysis revealed that cancer patients had worse outcomes than noncancer patients (log-rank p < 0.001). Patients who died had a significantly higher baseline PLR than those who survived both in the cancer (p = 0.009) and noncancer (p = 0.027) groups. Multivariable analyses showed that the PLR (by 100 increase) was an independent predictor of adverse outcomes in both cancer (hazard ratio: 1.07; 95% confidence interval: 1.02 to 1.13; p = 0.006) and noncancer (hazard ratio: 1.20; 95% confidence interval: 1.06 to 1.36; p = 0.004). The highest mortality was observed for patients with cancer and increased PLR (above the median) (log-rank p < 0.001). Conclusions: Cancer patients undergoing TAVR had a significantly higher PLR than those without cancer. Higher PLR was associated with a worse outcome following TAVR.

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