Using platelet-to-hemoglobin ratio as a predictor of cardiovascular disease outcomes

By Samar Mahmoud, MS
Published January 25, 2022

Key Takeaways

  • This observational, single center study found that elevated platelet-to-hemoglobin ratio (PHR) is associated with an increased risk of long-term all-cause mortality in coronary artery disease (CAD) patients with complications of congestive heart failure (CHF). 

  • These results indicate that PHR is a useful prognostic tool that can be used to identify high-risk patients in need of further interventions.

Previous work has established that high platelet counts and low hemoglobin levels are associated with adverse cardiovascular disease outcomes. Combining these two markers has been shown to be a better predictor for adverse outcomes than either platelet counts or hemoglobin levels alone.

Why This Study Matters

While PHR was shown to predict long-term negative outcomes in CAD patients who received a percutaneous coronary intervention, the link between PHR and all-cause mortality in CAD patients with heart failure has not been explored. This study aimed to fill this gap by investigating the relationship between PHR and mortality in patients with CAD complicated with CHF.

Study Design

The study included 2599 hospitalized patients who underwent coronary angiography (CAG) and received a diagnosis of CAD complicated by CHF from January 2007 to December 2018. 

The average participant age was 66.3 ± 10.9 years and females comprised 25.4 % of subjects. Investigators defined low PHR as <1.69 and high PHR as ≥ 1.69. 

The primary endpoint of the study was long-term all-cause mortality which was defined as any death that occurred from the date of enrollment in the study to the date of the last follow-up visit. The median follow-up period was 5.2 years. 

Results and Conclusions

Long-term all-cause mortality in the high PHR group was 41.1% in comparison to 34.7% in the low PHR group, which was a statistically significant difference.  

After adjusting for confounding factors among patients, investigators determined that high PHR increased all-cause mortality by 31%. 

In a subgroup analysis, researchers demonstrated that high PHR was associated with an increased risk of death among participants within the following subgroups: male, age <75, non-chronic kidney disease, and those who received a percutaneous coronary intervention. 

Related Research

Consider these findings from similar research studies:

  • Elevated platelet-to-lymphocyte ratio is associated with stable coronary artery disease (Source). 

  • Platelet-to-hemoglobin ratio predictor of adverse outcomes in patients after percutaneous coronary intervention (Source).

Share with emailShare to FacebookShare to LinkedInShare to Twitter