Platelet to Lymphocyte Ratio to Stratify Risk in CAD

The platelet to lymphocyte ratio may aide in stratifying risk in coronary artery disease.

The platelet to lymphocyte ratio (PLR) may aide in stratifying risk in coronary artery disease (CAD), according to the results of a meta-analysis published in Angiology.

Publication databases were searched through October 2019 for studies in the relationship between PLR and CAD was examined. A total of 14 studies (n=4871) were included in the final analysis, of which 11 were cohort studies, 2 were case-control studies, and 1 was a cross-sectional study. The analyses investigated the relationship between PLR and stable CAD (n=8), PLR and coronary slow flow (CSF; n=4), PLR and stable CAD by severity (n=3), and PLR and coronary collateral circulation (CCC; n=2). The studies were conducted in Turkey (n=11), China (n=1), Egypt (n=1), and India (n=1).

Patients with stable CAD had a higher PLR compared with control individuals (weighted mean difference [MD], 21.71; 95% CI, 10.16-33.26; P =.002), and patients with atherosclerosis had higher PLR than control individuals (MD, 32.39; 95% CI, 20.74-44.05; P <.001). PLR increased with the severity of atherosclerosis (MD, 26.76; 95% CI, 23.73-29.79; P <.001).

Patients with poor vs good CCC had higher PLR (MD, -24.32; 95% CI, -28.28 to -20.37; P <.001), and those with CSF had higher PLR compared with individuals with normal coronary flow (MD, 49.01; 95% CI, 11.10-86.92; P =.01).

Study limitations include the high levels of heterogeneity between studies examining the relationship between PLR and stable CAD, atherosclerosis, and CSF.

“Platelet to lymphocyte ratio, as a simple, cost-effective biomarker, may be useful for stratification of high-risk patients with stable CAD,” concluded the study authors.  


Qiu Z, Jiang Y, Jiang X, et al. Relationship between platelet to lymphocyte ratio and stable coronary artery disease: Meta-analysis of observational studies. Angiology. 20202;3319720943810. doi:10.1177/0003319720943810