Correlation Between Platelet-to-Lymphocyte Ratio and Low-Density Lipoprotein Cholesterol Levels in Patients With Coronary Heart Disease

Budiono Raharjo; Halimah Siahaan; Muhammad Sungging  Pradana; Halik Wijaya; Avena Athalia Alim; Yohanes Timothy Raharjo; Stephani Linggawan; Anton Sumarpo

doi:10.56303/jhnresearch.v5i1.951

Authors

Budiono Raharjo Faculty of Medicine, Universitas Wijaya Kusuma Surabaya, Indonesia
Halimah Siahaan Faculty of Health Sciences, Universitas Maarif Hasyim Latif, Indonesia
Muhammad Sungging Pradana Faculty of Health Sciences, Universitas Maarif Hasyim Latif, Indonesia
Halik Wijaya Faculty of Health Sciences, Universitas Maarif Hasyim Latif, Indonesia
Avena Athalia Alim Faculty of Medicine, Universitas Kristen Maranatha, Indonesia
Yohanes Timothy Raharjo Faculty of Medicine, Universitas Katolik Widya Mandala Surabaya, Indonesia
Stephani Linggawan Faculty of Medicine, Universitas Wijaya Kusuma Surabaya, Indonesia
Anton Sumarpo Faculty of Medicine, Universitas Kristen Maranatha, Indonesia

Keywords:

Coronary Heart Disease, Dyslipidemia, Inflammation, Low-Density Lipoprotein Cholesterol, Platelet-to-Lymphocyte Ratio

Abstract

Coronary heart disease (CHD) remains a leading cause of mortality worldwide and is primarily driven by atherosclerosis, a pathological process in which dyslipidemia and chronic inflammation play central roles. Elevated low-density lipoprotein (LDL) cholesterol is a well-established risk factor for atherogenesis, contributing to lipid accumulation within the arterial wall and subsequent plaque formation. In parallel, inflammatory mechanisms are critically involved in plaque progression and instability, underscoring the importance of inflammatory biomarkers in cardiovascular research. The platelet-to-lymphocyte ratio (PLR) has emerged as a simple and cost-effective hematological marker that reflects systemic inflammation and prothrombotic activity. Several studies have reported an association between elevated PLR and adverse cardiovascular outcomes. However, the relationship between PLR and lipid parameters, particularly LDL cholesterol, remains unclear. Previous findings have been inconsistent, and limited evidence is available regarding this association in patients with stable and medically treated CHD. Given these uncertainties, further investigation is warranted to clarify the relationship between inflammatory markers and lipid profiles in stable CHD populations. Therefore, this study aimed to evaluate the correlation between the platelet-to-lymphocyte ratio and LDL cholesterol levels in patients with stable coronary heart disease.

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References

Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. J Am Coll Cardiol. 2020 Dec 22;76(25):2982–3021.

Raharjo B, Kurniawati R, Wijayanti CDW, Linggawan S, Sumarpo A, Bintoro SUY. Hubungan rasio monosit/high density lipoprotein (HDL) dengan indeks massa tubuh pada pasien dengan penyakit jantung koroner. Holistik J Kesehat. 2025;19(2):349–54.

Sumarpo A, Efawati S, Ngibad K, Raharjo B, Linggawan S. Analisis Rasio Monosit terhadap Limfosit pada Penderita Osteoartritis di Surabaya. MAHESA Malahayati Health Stud J. 2025;5(5):2137–44.

Gaggini M, Gorini F, Vassalle C. Lipids in Atherosclerosis: Pathophysiology and the Role of Calculated Lipid Indices in Assessing Cardiovascular Risk in Patients with Hyperlipidemia. Int J Mol Sci. 2022 Dec 21;24(1):75.

Bekbossynova M, Saliev T, Ivanova-Razumova T, Andossova S, Kali A, Myrzakhmetova G. Beyond Cholesterol: Emerging Risk Factors in Atherosclerosis. J Clin Med. 2025 Jan;14(7):2352.

Fan W, Wei C, Liu Y, Sun Q, Tian Y, Wang X, et al. The Prognostic Value of Hematologic Inflammatory Markers in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention. Clin Appl Thromb. 2022 Dec 25;28:10760296221146183.

Bucurica S, Nancoff AS, Dutu M, Mititelu MR, Gaman LE, Ioniță-Radu F, et al. Exploring the Relationship between Lipid Profile, Inflammatory State and 25-OH Vitamin D Serum Levels in Hospitalized Patients. Biomedicines. 2024 Aug;12(8):1686.

Lu M, Zhang Y, Shi L, Wang Q, Yang X, Ma H, et al. Association of Blood Cell-Derived Inflammatory Markers with Symptoms and Short-Term Treatment Response in Late-Life Depression. Neuropsychiatr Dis Treat. 2025 Aug 25;21:1751–60.

Liao M, Liu L, Bai L, Wang R, Liu Y, Zhang L, et al. Correlation between novel inflammatory markers and carotid atherosclerosis: A retrospective case-control study. PLOS ONE. 2024 May 29;19(5):e0303869.

Alagoz AN, Dagdas A, Bunul SD, Erci GC. The Relationship Between Systemic Inflammatory Index and Other Inflammatory Markers with Clinical Severity of the Disease in Patients with Parkinson’s Disease. Biomedicines. 2025 Aug;13(8):2029.

Zeng G, Zhang C, Song Y, Zhang Z, Xu J, Liu Z, et al. The potential impact of inflammation on the lipid paradox in patients with acute myocardial infarction: a multicenter study. BMC Med. 2024 Dec 23;22(1):599.

Żurański W, Nowak J, Danikiewicz A, Zubelewicz-Szkodzińska B, Hudzik B. Assessing Cardiovascular Risk in Geriatric Patients Without Atherosclerotic Cardiovascular Disease. J Clin Med. 2024 Jan;13(23):7133.

Tesauro M, Mauriello A, Rovella V, Annicchiarico-Petruzzelli M, Cardillo C, Melino G, et al. Arterial ageing: from endothelial dysfunction to vascular calcification. J Intern Med. 2017;281(5):471–82.

Einarson TR, Acs A, Ludwig C, Panton UH. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007–2017. Cardiovasc Diabetol. 2018 June 8;17(1):83.

Ghaemian A, Nabati M, Saeedi M, Kheradmand M, Moosazadeh M. Prevalence of self-reported coronary heart disease and its associated risk factors in Tabari cohort population. BMC Cardiovasc Disord. 2020 May 19;20(1):238.

Sumarpo A, Fenny F, Suraya N. Kajian Pustaka: Hipertensi Renovaskuler. J Ilmu Kedokt Dan Kesehat. 2025;12(1):168–76.

Kong P, Cui ZY, Huang XF, Zhang DD, Guo RJ, Han M. Inflammation and atherosclerosis: signaling pathways and therapeutic intervention. Signal Transduct Target Ther. 2022 Apr 22;7(1):131.

Cai L, Yan J, Sun L, Dan W. TyG index and CBC-derived inflammatory indicators individual and mixed effects on all-cause and cardiovascular disease deaths in patients with CHD. Front Cardiovasc Med [Internet]. 2025 Sept 10 [cited 2025 Oct 13];12. Available from: https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1600097/full

Babes EE, Radu AF, Cretu NA, Bungau G, Diaconu CC, Tit DM, et al. Risk Stratification in Acute Coronary Syndromes: The Systemic Immune-Inflammation Index as Prognostic Marker. Med Sci. 2025 Sept;13(3):116.

Indrati AR, Kosasih FN, Fadhilah F, Pratiwi A, Muthiah U, Logito V, et al. Elevated Levels of Pro-Inflammatory Interleukin-6 in HIV Immunological Non-Responders Among the Indonesian Population. Diagn Basel Switz. 2025 Apr 10;15(8):959.

Gholizade M, Farhadi A, Marzban M, Mahmudpour M, Nabipour I, Kalantarhormozi M, et al. Association between platelet, white blood cell count, platelet to white blood cell ratio and sarcopenia in community-dwelling older adults: focus on Bushehr Elderly Health (BEH) program. BMC Geriatr. 2022 Apr 8;22(1):300.

Verawati B, Riyadi H, Khomsan A, Ekayanti I. Lifestyle behaviors and risk of metabolic syndrome: a case-control study among fishermen and oil palm farmers. J Health Nutr Res. 2025;4(3).

Wicaksono MG, Burahman H, Lestari YD. Assessment of coronary heart disease risk among medical faculty members using the Jakarta Cardiovascular Score (JAKVAS). J Health Nutr Res. 2025;4(2).

Elsadai E, Trisyani Y, Nuraeni A. Nutritional, physical activity, and mental health interventions to enhance cardiovascular health: a scoping review. J Health Nutr Res. 2025;4(3).