Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio are Predictors of Heart Failure

Abstract

BackgroundNeutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are inflammatory markers used as prognostic factors in various diseases. The aims of this study were to compare the PLR and the NLR of heart failure (HF) patients with those of age-sex matched controls, to evaluate the predictive value of those markers in detecting HF, and to demonstrate the effect of NLR and PLR on mortality in HF patients during follow-up.MethodsThis study included 56 HF patients and 40 controls without HF. All subjects underwent transthoracic echocardiography to evaluate cardiac functions. The NLR and the PLR were calculated as the ratio of neutrophil count to lymphocyte count and as the ratio of platelet count to lymphocyte count, respectively. All HF patients were followed after their discharge from the hospital to evaluate mortality, cerebrovascular events, and re-hospitalization.ResultsThe NLR and the PLR of HF patients were significantly higher compared to those of the controls (p < 0.01). There was an inverse correlation between the NLR and the left ventricular ejection fraction of the study population (r: -0.409, p < 0.001). The best cut-off value of NLR to predict HF was 3.0, with 86.3% sensitivity and 77.5% specificity, and the best cut-off value of PLR to predict HF was 137.3, with 70% sensitivity and 60% specificity. Only NLR was an independent predictor of mortality in HF patients. A cut-off value of 5.1 for NLR can predict death in HF patients with 75% sensitivity and 62% specificity during a 12.8-month follow-up period on average.ConclusionNLR and PLR were higher in HF patients than in age-sex matched controls. However, NLR and PLR were not sufficient to establish a diagnosis of HF. NLR can be used to predict mortality during the follow-up of HF patients.

Neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio as predictors of survival after heart transplantation

“…We have found that NLR was a more useful marker at ROC curve, similar to studies in HF. 28,29 Besides, in our study, NLR-but not PLR-was independently associated with 1 year mortality on multivariate analysis, in accordance with one study in HF. 28 Moreover, NLR was also associated with increased in-hospital mortality.…”

“…Although both markers have shown prognostic value in several cardiac conditions, few studies have compared them. We have found that NLR was a more useful marker at ROC curve, similar to studies in HF 28, 29. Besides, in our study, NLR—but not PLR—was independently associated with 1 year mortality on multivariate analysis, in accordance with one study in HF 28.…”

“…NLR AUC in our study in HTX showed better performance for in‐hospital mortality compared with the AUC for predicting major adverse cardiovascular events after percutaneous coronary interventions,26 or saphenous vein graft disease,27 and atrial fibrillation20 after CABG. On the contrary, other studies have showed better NLR AUC for mortality both in HF28, 29 and in non‐ST elevation myocardial infarction 30. The results for PLR were different, and most studies have showed a better predictive value in ST elevation myocardial infarction,13, 14, 15 HF,28, 29 and transcatheter aortic valve replacement,21 and after percutaneous coronary interventions26 or after implantable cardioverter defibrillator placement 18.…”

“…On the contrary, other studies have showed better NLR AUC for mortality both in HF28, 29 and in non‐ST elevation myocardial infarction 30. The results for PLR were different, and most studies have showed a better predictive value in ST elevation myocardial infarction,13, 14, 15 HF,28, 29 and transcatheter aortic valve replacement,21 and after percutaneous coronary interventions26 or after implantable cardioverter defibrillator placement 18. Of note, only few studies analysed the predictive value of PLR for mortality, and most showed predictive value in surrogate endpoints.…”

Importance of haemogram parameters for prediction of the time of birth in women diagnosed with threatened preterm labour

“…Indices, such as the NLR and PLR, are useful in the prognostic follow-up of diseases, such as acute coronary syndrome, ulcerative colitis, diabetes, obstructive sleep apnoea, Sj€ ogren syndrome, and systemic lupus erythematosus with predominant inflammatory activity. [33][34][35] The PLR has a significant relationship with cancer and inflammatory diseases, similar to the NLR. 36,37 Preterm birth is among the most important causes of perinatal morbidity and mortality.…”