The impact of platelet-to-lymphocyte ratio on clinical outcomes in heart failure: a systematic review and meta-analysis.

BACKGROUND: Inflammation has been suggested to play a role in heart failure (HF) pathogenesis. However, the role of platelet-to-lymphocyte ratio (PLR), as a novel biomarker, to assess HF prognosis needs to be investigated. We sought to evaluate the impact of PLR on HF clinical outcomes. METHODS: English-published records in PubMed/Medline, Scopus, and Web-of-science databases were screened until December 2023. Relevant articles evaluated PLR with clinical outcomes (including mortality, rehospitalization, HF worsening, and HF detection) were recruited, with PLR difference analysis based on death/survival status in total and HF with reduced ejection fraction (HFrEF) patients. RESULTS: In total, 21 articles (n = 13,924) were selected. The total mean age was 70.36 ± 12.88 years (males: 61.72%). Mean PLR was 165.54 [95% confidence interval (CI): 154.69-176.38]. In total, 18 articles (n = 10,084) reported mortality [either follow-up (PLR: 162.55, 95% CI: 149.35-175.75) or in-hospital (PLR: 192.83, 95% CI: 150.06-235.61) death rate] and the mean PLR was 166.68 (95% CI: 154.87-178.50). Further analysis revealed PLR was significantly lower in survived HF patients rather than deceased group (152.34, 95% CI: 134.01-170.68 versus 194.73, 95% CI: 175.60-213.85, standard mean difference: -0.592, 95% CI: -0.857 to -0.326, p < 0.001). A similar trend was observed for HFrEF patients. PLR failed to show any association with mortality risk (hazard ratio: 1.02, 95% CI: 0.99-1.05, p = 0.289). Analysis of other aforementioned outcomes was not possible due to the presence of few studies of interest. CONCLUSION: PLR should be used with caution for prognosis assessment in HF sufferers and other studies are necessary to explore the exact association.

Platelet to lymphocyte ratio and heart failureInflammation plays a role in heart failure (HF), and a blood test called the platelet-to-lymphocyte ratio (PLR) might be helpful in predicting patients' outcomes. We found that deceased HF patients had higher PLR values in comparison to those who survived, irrespective of cardiac pump function, with similar pattern for patients with decreased cardiac function (HF with reduced ejection fraction). However, this biomarker failed to show any significant association with death risk. In conclusion, PLR may have some potential to help predict HF prognosis, but it needs more research and physicians should probably be cautious about using PLR alone in clinical settings.

The Treatment Dilemma of Arteriopathy in Takayasu Arteritis- A State-of-the-Art Approach.

Takayasu Arteritis (TA) is a chronic idiopathic granulomatous pan-arteritis affecting the pulmonary artery, the aorta, and its principal derived branches. The majority of TA patients are female (82.9%-97.0%). Due to the inflammatory character of the illness, arterial stenosis therapy must be treated differently than the atherosclerosis process. In this review paper, we outline a strategy using real-world challenging cases.

Dynamic Behavior of Magnetically Affected Rod-Like Nanostructures with Multiple Defects via Nonlocal-Integral/Differential-Based Models.

Through considering both nonlocality and surface energy effects, this paper suggests suitable mathematical-continuum-based models for free vibration of nanorods with multiple defects acted upon by a bidirectional-transverse magnetic field. By employing both theories of elasticity of Eringen and Gurtin-Murdoch, the equations of motion for the magnetically affected-damaged rod-like nanostructures are derived using the nonlocal-differential-based and the nonlocal-integral-based models. The local defects are modeled by a set of linearly appropriate axial springs at the interface of appropriately divided nanorods. Through constructing the nonlocal-differential equations of motion for sub-divided portions and by imposing the appropriate interface conditions, the natural frequencies as well as the vibrational modes are explicitly obtained for fixed-free and fixed-fixed nanorods with low numbers of defects. The extracted nonlocal-integral governing equations are also solved for natural frequencies using the finite-element technique. For a particular situation, the model's results are successfully verified with those of another work. Subsequently, the effects of nonlocality, surface energy, defect's location, nanorod's diameter, magnetic field strength, and number of defects on the dominant free vibration response of the magnetically defected nanorods with various end conditions are displayed and discussed.

The relationship between serum vitamin D levels and ankle-brachial index in patients with metabolic syndrome.

BACKGROUND: Vitamin D deficiency is a prevalent condition in Iran and previous studies have shown that a low level of serum vitamin D is related to low ankle-brachial index (ABI). In the present study, the relationship of the serum level of vitamin D with ABI, as an index for atherosclerosis of peripheral arteries, was evaluated. METHODS: In this cross-sectional study, data on 91 patients with metabolic syndrome (Mets) from the Isfahan Cohort Study (ICS) were analyzed in order to evaluate the association between serum 25(OH) vitamin D level and ABI. The participants were divided into two groups; group A with desirable serum vitamin D level and group B with abnormal serum vitamin D level. ABI was measured and compared between these groups. RESULTS: A crude and adjusted model showed no association between vitamin D level and ABI in patients with MetS. CONCLUSION: It can be concluded that serum vitamin D level could not affect ABI in patients with MetS.

The association between the serum 25-hydroxyvitamin D level and cardiovascular events in individuals with and without metabolic syndrome.

BACKGROUND: Previous studies revealed that the level of 25-hydroxyvitamin D [25(OH)D] could be consider as one the risk factors for the occurrence of cardiovascular diseases (CVDs). This study aimed to evaluate the relationship between serum 25(OH)D level and CVD events in individuals with and without metabolic syndrome (MetS) in an Iranian population. METHODS: In this nested case-control study conducted as a part of the Isfahan Cohort Study (ISC), 55 patients with CVD events were selected as case group, and 55 sex- and age-matched individuals without CVD events as control group. These participants were divided into the two main groups based on the presence of MetS at baseline. RESULTS: The level of 25(OH)D in individuals with and without MetS was significantly lower among patients with CVD compared to those without CVD events at the baseline of study and after the follow-up (P = 0.036 and P = 0.039, respectively). The level of 25(OH)D significantly decreased risk of incidence of CVD events in individuals without MetS after adjusting for age, sex, nutrition, and exposure to sunlight [0.19 (0.05-0.73); P = 0.016]. There was not any significant relationship between the amount of 25(OH)D at the baseline and CVD events in individuals with MetS. CONCLUSION: In individuals with MetS, the level of 25(OH)D is not related to CVD events; as MetS directly influence the pathophysiology of mechanisms which are responsible for CVD events, and maybe this effect obscure the effect of 25(OH)D.