Platelet-large cell ratio (P-LCR) is defined as the percentage of platelets that exceed the normal value of platelet volume of 12 fL in the total platelet count.
Platelet size has been shown to reflect platelet activity; therefore MPV (=Mean Platelet Volume) and P-LCR are a simple and easy method of indirect assessment of platelet stimulation.
Platelets represent an important link between inflammation and thrombosis and play an important role in all stages of atherosclerotic lesion formation. Increased platelet activity and their tendency to clot formation favour the incidence of thrombotic complications, such as unstable angina pectoris (UA), myocardial infarction (MI) and sudden cardiac death, in the course of coronary artery disease (CAD). Mean platelet volume (MPV) reflects the average size of platelets and, under normal circumstances, ranges between 7.5 fL to 10.5 fL.
In general population, higher MPV values are associated with increased risk of CAD. Higher MPV and P-LCR values are observed in CAD patients compared to patients without coronary atherosclerosis. In acute coronary syndromes (ACS) the MPV value is higher in patients with myocardial infarction than in patients with unstable CAD. In cases of stable CAD, elevated MPV correlates with the severity of coronary artery involvement and is a predictive factor of ACS. In patients with acute MI high MPV value has been reported to have impact on the no-reperfusion phenomenon following a percutaneous coronary intervention (PCI). Therefore, MPV and P-LCR indices, combined with other prognostic parameters, may be an important element of various scoring systems used in long-term prognosis in both stable CAD and ACS.
P-LCR is significantly decreased in patients with thrombocytosis. Thrombocytosis is a condition in which there are an excessive number of platelets in the blood. Platelets are blood cells in plasma that stop bleeding by sticking together to form a clot.
Increased percentage of large platelets (P-LCR) is observed in patients with Hyperlipidaemia and suggest possible risk of thrombosis.
- Hyperlipidaemia is often found when people are overweight or have an unhealthy diet. It can also be the result of drinking too much alcohol.
- Thrombosis is the formation of a blood clot, known as a thrombus, within a blood vessel. It prevents blood from flowing normally through the circulatory system.
P-LCR can also be increased in thrombocytopenia.
- Thrombocytopenia is a condition characterized by abnormally low levels of platelets, also known as thrombocytes, in the blood.
An increase in P-LCR + MPV + PDW has been observed in autoimmune thrombocytopenic purpura.
- Idiopathic thrombocytopenic purpura [aka Immune thrombocytopenia (ITP)] is an immune disorder in which the blood doesn't clot normally. This condition is now more commonly referred to as immune thrombocytopenia (ITP). ITP can cause excessive bruising and bleeding.
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