PlateletToLymphocyte Ratio as a Predictor of NoReflow after Primary Percutaneous Coronary Intervention in Patients with ST Elevation Myocardial Infarction: A Systematic Review and MetaAnalysis

Introduction: Noreflow increases the complications and mortality rate of primary percutaneous coronary intervention (PCI). Therefore, it is important to identify patients at a higher risk of developing noreflow. This study aimed to systematically review the prognostic value of the platelettolymphocyte ratio (PLR) to predict noreflow. Materials and Methods: The databases, such as Pubmed, EMBASE, and Web of Knowledge were searched for the relevant studies. Two authors independently performed data extraction and quality assessment of the included studies. In this metaanalysis, sensitivity and specificity of PLR, as well as the pooled odds ratio were calculated to predict noreflow and compared with the pooled means of PLR in noreflow and reflow groups. Results: According to the results obtained from six out of eight studies in this systematic review, there was a significant association between PLR and noreflow. Moreover, a pooled sixfold increase of noreflow risk was observed in the high PLR group. Pooled sensitivity and specificity of PLR to predict noreflow was 65% (CI95%: 61%69%) and 77% (CI95%: 76%79%), respectively. The mean pooled of PLR in the noreflow group was significantly 65.2 (CI95%: 26.7103.8) units higher than that in the reflow group. Conclusions: The PLR is a significant predictor of noreflow in STEMI patients subjected to primary PCI which can be used alone or in combination with other markers to identify patients at higher risk of developing noreflow.