Association of Platelet Lymphocyte Ratio (PLR) and Neutrophil Lymphocyte Ratio (NLR) with Global Registry of Acute Coronary Events (GRACE) Score in Acute Coronary Syndrome

Abstract

Introduction: Acute Coronary Syndrome (ACS) has morbidity and mortality significantly increase, it requires risk stratification for the assessment and selection of initial invasive strategies. The Global Registry of Acute Coronary Events (GRACE) scores recommended as risk stratification of ACS. Some of studies found that the combination of GRACE scores with other clinical and laboratory parameters can increase predictive value of ACS. Platelet Lymphocyte Ratio (PLR) and Neutrophil Lymphocyte Ratio (NLR) act as parameter of systemic inflammation in ACS. Aims of the study to determine the association between PLR and NLR with risk stratification GRACE score. Method: This study is analytical with a cross-sectional retrospective design. This study included 70 patients with a diagnosis of ACS based on medical record data. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) 22.0. P-value <0.05 was considered statistically significant. Results: This study was found a positive correlation between PLR and NLR with the GRACE score of patients ACS (r=0.485, p<0.001; r=0.570, p<0.001). The PLR and NLR were both found the significantly higher in the high risk GRACE score respectively (188 ± 47, p < 0.001; 7.9± 2.7, p<0.001). The ROC curve analysis, cutt-off PLR of 123 and above (sensitivity of 72.7 %; specificity of 70.3), while cutt-off NLR of 4 and above (sensitivity of 78.8%; specificity of 70.3%) to detect high risk GRACE score. Conclusion: There is a significant association between PLR and NLR with GRACE score Keywords: Platelet Lymphocyte Ratio, Neutrophil Lymphocyte Ratio, GRACE score, Acute Coronary Syndrome.