Association of Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratio with Adverse Events in Endovascular Repair for Abdominal Aortic Aneurysm

Maria P Ntalouka; Petroula Nana; George N Kouvelos; Konstantinos Stamoulis; Konstantinos Spanos; Athanasios Giannoukas; Miltiadis Matsagkas; Eleni Arnaoutoglou

doi:10.3390/jcm10051083

Association of Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratio with Adverse Events in Endovascular Repair for Abdominal Aortic Aneurysm

J Clin Med. 2021 Mar 5;10(5):1083. doi: 10.3390/jcm10051083.

Authors

Maria P Ntalouka¹, Petroula Nana², George N Kouvelos², Konstantinos Stamoulis¹, Konstantinos Spanos², Athanasios Giannoukas², Miltiadis Matsagkas², Eleni Arnaoutoglou¹

Affiliations

¹ Department of Anesthesiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece.
² Department of Vascular Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece.

Abstract

The association of chronic inflammatory markers with the clinical outcome after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) was investigated. We included 230 patients, treated electively with EVAR. The values of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were measured pre- and postoperatively. Any major adverse cardiovascular event (MACE) and acute kidney injury (AKI) were recorded. Adverse events occurred in 12 patients (5.2%). Seven patients suffered from MACE and five from AKI. Median NLR and PLR values were significantly increased after the procedure (NLR: from 3.34 to 8.64, p < 0.001 and PLR: from 11.37 to 17.21, p < 0.001). None of the patients or procedure characteristics were associated with the occurrence of either a MACE or AKI. Receiver operating characteristic curve analysis showed that postoperative NLR and PLR were strongly associated with AKI. A threshold postoperative NLR value of 9.9 was associated with the occurrence of AKI, with a sensitivity of 80% and specificity of 81%. A threshold postoperative PLR value of 22.8 was associated with the occurrence of AKI, with a sensitivity of 80% and specificity of 83%. Postoperative NLR and PLR have been associated with the occurrence of AKI after EVAR for AAA.

Keywords: abdominal; acute kidney injury; aortic aneurysm; biomarkers/blood; blood platelets/surgery; endovascular procedures; lymphocyte/surgery.