SO SÁNH GIÁ TRỊ DỰ ĐOÁN BIẾN CỐ NỘI VIỆN CỦA TỈ SỐ TIỂU CẦU – LYMPHO BÀO VỚI CÁC THANG ĐIỂM TIÊN LƯỢNG HIỆN HÀNH Ở BỆNH NHÂN NHỒI MÁU CƠ TIM CẤP

Abstract

Background: Prognostic scoring systems and cardiac biomarkers have significantly aided in the management of patients with acute myocardial infarction (AMI); however, their application remains limited due to their complexity. The platelet-to-lymphocyte ratio (PLR), a simple and readily available hematologic index, has been proposed as a potential prognostic tool. Objective: To evaluate and compare the prognostic value of PLR with the Killip classification, GRACE score, and neutrophil-to-lymphocyte ratio (NLR) in predicting in-hospital cardiovascular events in patients with AMI. Methods: A retrospective analytical study was conducted on 112 patients with AMI admitted to the Interventional Cardiology Department, University Medical Center Ho Chi Minh City, from January 2023 to January 2025. PLR was calculated from the platelet and lymphocyte counts at admission. Receiver operating characteristic (ROC) curve analysis was performed to determine the area under the curve (AUC) of PLR, Killip, GRACE, and NLR for predicting in-hospital adverse events. Results: Patients with PLR >152.91 had significantly longer hospital stays (6.73±5.6 vs. 5.02±3.06 days; p=0.024) and higher rates of in-hospital cardiovascular events, including cardiogenic shock (28.4% vs. 8.9%; p=0.012), pump failure (44.8% vs. 13.3%; p<0.001), and death (14.9% vs. 2.2%; p=0.048). The AUC for PLR was 0.749 (95%CI: 0.658–0.826), which was not significantly different from Killip (0.839), GRACE (0.846), and NLR (0.808) (all p>0.05). Conclusions: PLR demonstrated a prognostic value for in-hospital adverse events comparable to that of established scoring systems (Killip, GRACE) and NLR. As a simple, cost-effective, and widely accessible marker, PLR could serve as a useful adjunctive tool for early risk stratification in AMI, especially in resource-limited settings.