Platelet-Lymphocyte Ratio Applications in Cardiovascular Diseases

The platelet-lymphocyte ratio (PLR) has emerged as a simple, cost-effective biomarker that integrates platelet-driven thrombotic risk with lymphocyte-mediated immune status. In cardiovascular disease, a high PLR reflects heightened systemic inflammation and a prothrombotic milieu, both of which contribute to plaque instability, myocardial injury and poorer clinical outcomes. PLR measurement is readily available from routine full blood counts, offering clinicians an adjunctive tool for risk stratification across a spectrum of presentations, from acute coronary syndromes to post-procedural recovery and functional capacity assessment. Its predictive value spans in-hospital mortality, long-term adverse events and exercise tolerance, with cut-off values tailored to specific patient populations and clinical settings.

Research from Nature Portfolio

A seminal meta-analysis established PLR as a robust predictor of adverse outcomes in acute coronary syndrome, demonstrating that patients with elevated PLR face over twice the risk of in-hospital and long-term cardiovascular events compared with those at lower levels. This finding underlines the role of systemic inflammation in driving clinical deterioration after plaque rupture. Complementing this, a large observational study in the cardiac intensive care unit revealed that higher PLR quartiles were independently associated with increased in-hospital mortality and longer intensive care and hospital stays. These data reinforce PLR as an independent prognostic indicator in critically ill cardiac patients, with potential utility for early risk identification and resource allocation.

Platelet-Lymphocyte Ratio Applications in Cardiovascular Diseases publication trend

The graph below shows the total number of articles in platelet-lymphocyte ratio applications in cardiovascular diseases across all publications each year (not limited to Nature Index journals).

Technical terms

Platelet-Lymphocyte Ratio (PLR): the quotient of peripheral blood platelet count divided by lymphocyte count, reflecting the interplay of thrombosis and inflammation.

Acute Coronary Syndrome (ACS): a spectrum of conditions including unstable angina and myocardial infarction caused by sudden reduction of coronary blood flow.

Cardiac Intensive Care Unit (CICU): a specialised hospital ward dedicated to the management of patients with life-threatening cardiovascular conditions.

Percutaneous Coronary Intervention (PCI): a minimally invasive procedure employing balloon angioplasty and stent placement to restore coronary artery patency.

Major Adverse Cardiac Events (MACE): a composite endpoint comprising cardiovascular death, myocardial infarction and repeat revascularisation.

Cardiopulmonary Exercise Testing (CPET): an exercise assessment measuring oxygen uptake and ventilatory parameters to evaluate functional capacity and prognosis in cardiac patients.

References

1. Platelet to lymphocyte ratio in the prediction of adverse outcomes after acute coronary syndrome: a meta-analysis. Scientific Reports (2017).
2. Platelet-lymphocyte ratio as a new predictor of in-hospital mortality in cardiac intensive care unit patients. Scientific Reports (2021).
3. Platelet‐to‐lymphocyte ratio a potential prognosticator in acute myocardial infarction: A prospective longitudinal study. Clinical Cardiology (2023).
4. Value of the Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio in Predicting CPET Performance in Patients with Stable CAD and Recent Elective PCI. Medicina (2022).