Prognostic value of the combination of TIMI risk score and mean platelet volume to lymphocyte count ratio in patients with acute coronary syndrome

Abstract

Background: Thrombolysis In Myocardial Infarction (TIMI) risk score and MPV/lymphocyte ratio (MPVLR) are important parameters that can be used to predict mortality and major cardiovascular adverse events (MACE) in patients with acute coronary syndrome (ACS). However, the prognostic value of a modified score system that is based on the relationships and combinations of these parameters in ACS patients is unknown. Hence, we aimed to investigate the relationship between the modified risk score obtained by the combination of TIMI risk score and MPVLR with 2-year-long MACE and mortality in ACS patients. Method: In this study, 472 consecutive patients with a diagnosis of ACS, who were revascularized using percutaneous coronary intervention, were included. The patients were evaluated in groups of two, namely MACE (+) and MACE (–), and also as “High” and “Low” according to the cut-off value of the MPVLR + TIMI modified score. Results: The area under the curve values of the modified MPVLR + TIMI for two-year MACE and mortality prediction were found to be 0.893 (0.812–0.974, p < 0.001) and 0.864 (0.715–1.00, p = 0.001), respectively, and were observed to be superior to the individual MPVLR and TIMI scores. In the Kaplan–Meier survival analysis, it was detected that the MPVLR + TIMI combination score for long-term MACE and mortality (log rank: 59.329, p <0.001 and log rank: 12.085, p = 0.001, respectively) was superior to individual MPVLR and TIMI scores. In the Cox regression analysis performed to determine long-term MACE risk factors, the MPVLR + TIMI combination score (HR: 5.41, p = 0.006) was noted to be superior to MPVLR (HR: 2.88, p = 0.094), TIMI score (HR: 2.92, p = 0.099), and other variables. Conclusion: The modified MPVLR + TIMI score was found to be superior to the MPVLR and TIMI score individually in predicting 2-year mortality and MACE in ACS patients.