Relationship Between Platelet to Lymphocyte Ratio and Presence of Spontaneous Echo Contrast in Patients With Mitral Stenosis

Abstract

Objective: To evaluate the relationship between platelet-to-lymphocyte ratio (PLR) and spontaneous echo contrast (SEC) in patients diagnosed with mitral stenosis.

Methodology: This comparitive cross-sectional study was conducted for six months (Nov 2024 to April 2025) at the Cardiology Department of Armed Forces Institute of Cardiology, National Institute of Heart Diseases, Rawalpindi. A consecutive sampling technique was employed to select diagnosed moderate to severe mitral stenosis patients aged ≥18 years. Transthoracic echocardiography (TTE) was performed to identify the presence of SEC. Total platelet count was divided by the lymphocyte count to calculate PLR.

Results: Overall, 100 patients (males: 67, female: 33) having mean age 42.06±7.38 years were the study participants. PLR was significantly elevated in SEC-positive individuals (150.98±44.65 vs. 129.77±50.04, p=0.036). The area under the ROC curve was 0.635, indicating moderate predictive ability. A PLR cutoff 115.23 yielded 80.9% sensitivity and 53.1% specificity, with 95% CI (0.513–0.757).  Binary logistic regression confirmed the predictive potential of PLR (β=0.010; 95% CI: 0.01(1.001-1.019) and the significant relationship between PLR and SEC (p<0.05).

Conclusion: PLR is significantly associated with SEC in mitral stenosis patients. Additionally, PLR shows potential as a predictor of SEC.

Keywords: Lymphocyte, Mitral Valve Stenosis, Platelet