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Peer-reviewedCC BY 4.0Reviews in Cardiovascular Medicine

Association Between Platelet Count/Lactate Dehydrogenase Ratio and In-Hospital Mortality in the Patients With Sepsis-Induced Myocardial Injury

  • Shuai Mao1,2,3
  • Xuan Zhang4
  • Yunzhang Zhao1,2,3
  • Chao Lv1
  • Huiyi Liu1
  • Yanzhu Yao1,2
  • Yuyan Wang1,2
  • Yifan Wang1,2
  • Shengshu Wang1
  • Jie Zhang1,2
  • Yong Xu2,3
  • Tong Yin1,2
4 affiliations
  1. 1Institute of Geriatrics, National Clinical Research Center for Geriatric Diseases, The Second Medical Center of Chinese PLA General Hospital, 100853 Beijing, China
  2. 2Medical School of Chinese PLA, Chinese PLA General Hospital, 100853 Beijing, China
  3. 3Senior Department of Cardiology, The Sixth Medical Center of PLA General Hospital, 100048 Beijing, China
  4. 4Department of Medical Innovation Research, Chinese PLA General Hospital, 100853 Beijing, China
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Abstract

Background:: Sepsis-induced myocardial injury (SIMI) is a severe complication with high mortality, yet effective prognostic prediction tools remain limited. Although platelet-derived indices have been explored in SIMI, these metrics primarily reflect systemic inflammation rather than the extent of myocardial injury or metabolic status.

Methods:: We retrospectively analyzed 3071 critically ill individuals with SIMI admitted to the intensive care unit (ICU) of the Chinese People’s Liberation Army (PLA) General Hospital between January 2020 and October 2025. The association between the platelet count (PLT)/lactate dehydrogenase (LDH) ratio and in-hospital mortality was assessed using multivariable Cox regression, restricted cubic splines, and receiver operating characteristic (ROC) curve analysis. Subgroup analyses evaluated consistency across clinically relevant strata.

Results:: The PLT/LDH ratio was independently associated with lower in-hospital mortality (hazard ratio [HR] = 0.44, 95% confidence interval [CI]: 0.34–0.57, p < 0.001). Compared with the lowest tertile, the highest tertile of PLT/LDH ratio was associated with a 67% reduction in risk (HR = 0.33, 95% CI: 0.25–0.43, p < 0.001). The PLT/LDH ratio demonstrated modest, statistically significant incremental discriminative performance over PLT or LDH alone (both p < 0.05). A nonlinear relationship was observed, with an inflection point at approximately 0.306 (p for nonlinearity < 0.0001). Subgroup analyses revealed a consistent association across all subgroups, with significant interactions for sex, hypertension, chronic kidney disease, and liver disease (all p for interaction < 0.05).

Conclusions:: The PLT/LDH ratio is independently associated with in-hospital mortality in patients with SIMI. It may serve as a simple and practical tool for prognostic prediction in patients with SIMI upon ICU admission.

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Cite

BibTeXRIS
BibTeX
@article{mao2026association,
  title = {{Association Between Platelet Count/Lactate Dehydrogenase Ratio and In-Hospital Mortality in the Patients With Sepsis-Induced Myocardial Injury}},
  author = {Shuai Mao and Xuan Zhang and Yunzhang Zhao and Chao Lv and Huiyi Liu and Yanzhu Yao and Yuyan Wang and Yifan Wang and Shengshu Wang and Jie Zhang and Yong Xu and Tong Yin},
  journal = {Reviews in Cardiovascular Medicine},
  year = {2026},
  month = oct,
  doi = {10.31083/rcm55645},
  url = {https://doi.org/10.31083/rcm55645},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Association Between Platelet Count/Lactate Dehydrogenase Ratio and In-Hospital Mortality in the Patients With Sepsis-Induced Myocardial Injury
AU  - Shuai Mao
AU  - Xuan Zhang
AU  - Yunzhang Zhao
AU  - Chao Lv
AU  - Huiyi Liu
AU  - Yanzhu Yao
AU  - Yuyan Wang
AU  - Yifan Wang
AU  - Shengshu Wang
AU  - Jie Zhang
AU  - Yong Xu
AU  - Tong Yin
PY  - 2026
DA  - 2026/10/22
JO  - Reviews in Cardiovascular Medicine
DO  - 10.31083/rcm55645
UR  - https://doi.org/10.31083/rcm55645
AB  - Background:: Sepsis-induced myocardial injury (SIMI) is a severe complication with high mortality, yet effective prognostic prediction tools remain limited. Although platelet-derived indices have been explored in SIMI, these metrics primarily reflect systemic inflammation rather than the extent of myocardial injury or metabolic status.  Methods:: We retrospectively analyzed 3071 critically ill individuals with SIMI admitted to the intensive care unit (ICU) of the Chinese People’s Liberation Army (PLA) General Hospital between January 2020 and October 2025. The association between the platelet count (PLT)/lactate dehydrogenase (LDH) ratio and in-hospital mortality was assessed using multivariable Cox regression, restricted cubic splines, and receiver operating characteristic (ROC) curve analysis. Subgroup analyses evaluated consistency across clinically relevant strata.  Results:: The PLT/LDH ratio was independently associated with lower in-hospital mortality (hazard ratio [HR] = 0.44, 95% confidence interval [CI]: 0.34–0.57, p < 0.001). Compared with the lowest tertile, the highest tertile of PLT/LDH ratio was associated with a 67% reduction in risk (HR = 0.33, 95% CI: 0.25–0.43, p < 0.001). The PLT/LDH ratio demonstrated modest, statistically significant incremental discriminative performance over PLT or LDH alone (both p < 0.05). A nonlinear relationship was observed, with an inflection point at approximately 0.306 (p for nonlinearity < 0.0001). Subgroup analyses revealed a consistent association across all subgroups, with significant interactions for sex, hypertension, chronic kidney disease, and liver disease (all p for interaction < 0.05).  Conclusions:: The PLT/LDH ratio is independently associated with in-hospital mortality in patients with SIMI. It may serve as a simple and practical tool for prognostic prediction in patients with SIMI upon ICU admission.
SN  - 1530-6550
SN  - 2153-8174
ER  -