Pretreatment Platelet-to-Lymphocyte Ratio- A Marker for Chronic Limb Threatening Ischaemia

Introduction: Peripheral Artery Occlusive Disease (PAOD) is a common global health condition. Delay in initiating treatment often leads to increased morbidity and mortality linked to the development of Chronic Limb Threatening Ischaemia (CLTI). Despite advances in revascularisation techniques, amputation and death rates remain high in PAOD cases. The conventional use of Ankle-Brachial Pressure Index (ABPI) as a diagnostic indicator for CLTI may not always be reliable. The Platelet-Lymphocyte Ratio (PLR) can aid in identifying CLTI cases due to its involvement in atherosclerosis pathogenesis in arteries. Aim: To compare the proportions of high PLR (PLR >150) and low PLR (PLR 30). Of the study subjects, 148 (87%) with PLR >150 had ABPI below 0.4 on the right side (p-value 0.001), and similarly, 138 (81%) cases with PLR >150 had ABPI below 0.4 on the left side (p-value 0.001). There was a direct and strong association between PLR value and ABPI. High PLR and low ABPI on the right side showed a statistically significant moderate negative correlation (-0.443), and low ABPI on the left side exhibited a statistically significant weak negative correlation (-0.287). Conclusion: High PLR (PLR >150) and low ABPI (less than 0.4) indicate CLTI in a PAOD case. PLR >150 can serve as a marker of CLTI. PLR was elevated in patients with increased CRP, highlighting the role of inflammatory markers as well.