Leuko-platelet index predicts thrombotic events in patients with acute coronary syndrome

To evaluate the predictive value of a bedside index in hospitalized patients with acute coronary syndromes (ACS). We studied the association of leuko-platelet index (LPI: platelet count * leukocyte count/108) with risk of mortality, shock, or heart failure (combined end point-CEP), and with the response to antiplatelet therapy, measured by light transmission aggregometry. In the derivation cohort we included 1100 patients with non STEM-ACS, GRACE score of 133 ± 52, Crusade score 24,3 ± 14, 66% male, 65 + 11 years. LPI was 17 (12–24). LPI was higher (19 (13–25)) in patients with MI than in patients with unstable angina (16 (12−22) in (p 140 (OR 8.1 (2.2–29), p = 0.02). LPI (OR 1.04 (1.004–1.07) p = 0.03) and GRACE score (OR 1.02 (1.01–1.03) p 24). Conclusions:LPI > 24 was associated to CEP (OR (1.7–5.2), p 0.01), independently of age (OR 1 (0.98–1.02), p = 0.8), and GRACE score (OR 1.01 (0.99–1.01), p 0.69), and It was associated to antiplatelet resistance (OR 1.03 (95% CI 1.00–1.06) p = 0.05). •The accurate risk stratification of acute coronary syndromes is crucial for the selection of the treatment.•Leukocytosis and increased platelet turnover have been associated to thrombotic events in ACS patients.•Leuko-platelet index > 24 was associated to cardiovascular events in patients with ACS, adding predictive value to GRACE score.•LPI was associated to resistance to antiplatelet treatment.