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

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 (tog-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. (C) 2019 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.