Neutrophil-to-lymphocyte ratio and in-hospital mortality in patients with acute heart failure

Turfan, Murat; Erdoğan, Ercan; Taşal, Abdurrahman; Vatankulu, Mehmet Akıf; Jafarov, Parviz; Sönmez, Osman; Ertaş, Gökhan; Bacaksız, Ahmet; Göktekín, Ömer

doi:10.6061/clinics/2014(03)08

Cited by 24 publications

(22 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…28) A higher N/L ratio has also been shown to be associated with an increased risk of in-hospital mortality in patients with acute heart failure. 15,29) In this study, the highest tertile of the N/L ratio was associated with an increased risk of MCE in elderly patients with CHF. We also found similar associations between the N/L ratio and cardiac death and rehospitalization for heart failure after multivariate adjustments.…”

Section: Discussionmentioning

confidence: 89%

Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting Adverse Events in Elderly Patients With Chronic Heart Failure

Yan

et al. 2016

Int. Heart J.

View full text Add to dashboard Cite

SummaryThe neutrophil-to-lymphocyte (N/L) ratio has been associated with poor outcomes in patients with cardiovascular diseases, but it has not been studied in elderly patients with chronic heart failure (CHF).In this study, we analyzed 1355 elderly patients admitted with CHF. A multivariate logistic regression model was used to assess the independent association of the N/L ratio with chronic kidney disease (CKD). The patients were then divided into tertiles according to the N/L ratios. We used Cox regression analysis to assess the association between the N/L ratio and subsequent major cardiovascular events (MCE), including cardiac death and rehospitalization for heart failure.In the multiple logistic regression analysis, the N/L ratio was identified as a risk factor for CKD in elderly patients with CHF (odds ratio [OR] = 1.170, 95% confidence interval [CI] 1.054 to 1.298, P = 0.003). The median follow-up period was 18 months. In a multivariate analysis with the lowest tertile as the reference, the highest tertile of the N/L ratio remained significantly associated with MCE (hazard ratio [HR] = 1.425, 95% CI 1.109 to 1.832, P = 0.006), cardiac death (HR = 1.747, 95% CI 1.032 to 2.958, P = 0.038), and rehospitalization for heart failure (HR = 1.461, 95% CI 1.108 to 1.927, P = 0.007).In elderly patients with CHF, the N/L ratio is one of the important risk factors for CKD and the highest tertile of the N/L ratio is associated with an increased risk for MCE. (Int Heart J 2016; 57: 615-621)

show abstract

Section: Discussionmentioning

confidence: 89%

Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting Adverse Events in Elderly Patients With Chronic Heart Failure

Yan

et al. 2016

Int. Heart J.

View full text Add to dashboard Cite

show abstract

“…NLR predicted in-hospital mortality with an AUC of 0.687 and a cut-off level > 4.78 with 66.7% sensitivity and 60.5% specificity [24]. In multivariate logistic regression, age, LVEF and NLR > 4.78 (OR 1.156, 95% CI 1.011-1.334, p = 0.048) were independent predictors of in-hospital mortality [24].…”

Section: In-hospital Mortality After Acute Decompensated Heart Failurementioning

confidence: 95%

Section: In-hospital Mortality After Acute Decompensated Heart Failurementioning

confidence: 99%

“…Another report of the utility of NLR in HF short-term prognosis is the study authored by Turfan el al., investigating a cohort of 167 patients with acute HF with reduced LVEF < 50% [24]. NLR predicted in-hospital mortality with an AUC of 0.687 and a cut-off level > 4.78 with 66.7% sensitivity and 60.5% specificity [24]. In multivariate logistic regression, age, LVEF and NLR > 4.78 (OR 1.156, 95% CI 1.011-1.334, p = 0.048) were independent predictors of in-hospital mortality [24].…”

Section: In-hospital Mortality After Acute Decompensated Heart Failurementioning

confidence: 99%

See 1 more Smart Citation

The neutrophil to lymphocyte ratio in heart failure: a comprehensive review

Delcea

Buzea

Dan

2019

Romanian Journal of Internal Medicine

View full text Add to dashboard Cite

Introduction. Heart failure (HF) and systemic inflammation are interdependent processes that continuously potentiate each other. Distinct pathophysiological pathways are activated, resulting in increased neutrophil count and reduced lymphocyte numbers, making the neutrophil to lymphocyte ratio (NLR) a potential indirect marker of severity. We conducted this comprehensive review to characterize the role of NLR in HF. Methods. We searched the PubMed (MEDLINE) database using the key words “neutrophil”, “lymphocyte”, “heart failure”, “cardiomyopathy”, “implantable cardioverter defibrillator”, “cardiac resynchronization therapy” and “heart transplant”. Results. We identified 241 publications. 31 were selected for this review, including 12,107 patients. NLR was correlated to HF severity expressed by clinical, biological, and imaging parameters, as well as to short and long-term prognosis. Most studies reported its survival predictive value. Elevated NLR (>2.1–7.6) was an independent predictor of in-hospital mortality [adjusted HR 1.13 (95% CI 1.01–1.27) – 2.8 (95% CI 1.43–5.53)] as well as long-term all-cause mortality [adjusted HR 1.43 (95% CI 1.1–1.85) – 2.403 (95% CI 1.076–5.704)]. Higher NLR levels also predicted poor functional capacity [NLR > 2.26/2.74, HR 3.93 (95% CI 1.02–15.12) / 3.085 (95% CI 1.52–6.26)], hospital readmissions [NLR > 2.9/7.6, HR 1.46 (95% CI 1.10–1.93) / 3.46 (95% CI 2.11–5.68)] cardiac resynchronization therapy efficacy [NLR > 3.45/unit increase, HR 12.22 (95% CI 2.16–69.05) / 1.51 (95% CI 1.01–2.24)] and appropriate implantable cardioverter defibrillator shocks (NLR > 2.93), as well as mortality after left ventricular assist device implantation [NLR > 4.4 / quartiles, HR 1.67 (95% CI 1.03–2.70) / 1.22 (95% CI 1.01–1.47)] or heart transplant (NLR > 2.41, HR 3.403 (95% CI 1.04–11.14)]. Conclusion. Increased NLR in HF patients can be a valuable auxiliary biomarker of severity, and most of all, of poor prognosis.

show abstract

“…3 Neutrophil-to-lymphocyte ratio (NLR) is an important determinant of inflammatory response 4 and has been proposed as a prognostic indicator in many clinical contexts, including short-term morbidity and mortality after acute ischemic stroke, ST segment-elevated myocardial infarction, and acute cardiac insufficiency. [5][6][7] NLR has also been used as a predictor of long-term morbidity and mortality in malignancy, autoimmune diseases, and metabolic syndrome. [8][9][10][11] In patients with ICH, NLR has been closely associated with 30-day mortality and 90-day disability as well as risk of cerebral hematoma enlargement.…”

Section: Introductionmentioning

confidence: 99%

Early increase of neutrophil‐to‐lymphocyte ratio predicts 30‐day mortality in patients with spontaneous intracerebral hemorrhage

Wang

Quan

et al. 2018

CNS Neurosci Ther

View full text Add to dashboard Cite

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. Results: A total of 275 subjects were included in the analysis: 235 survived for at least 30 days; the remaining 40 subjects died within 30 days. The patients who died within 30 days had higher ICH score, larger ICH volume, and lower GCS score (all P < 0.05). In comparison with the baseline (NLR T1 ), NLR at 24-48 hours (NLR T2 ) and 5-7 days (NLR T3 ) was significantly higher in patients who died within 30 days (P < 0.05), but not in patients surviving for >30 days. In the multivariate analysis, the 30-day mortality was associated with both NLR T2 (OR 1.112, 95%CI 1.032-1.199, P = 0.006) and NLR T3 (OR 1.163, 95%CI 1.067-1.268, P = 0.001). Spearman correlation analysis showed that both NLR T2 and NLR T3 correlated inversely with GCS score and positively with ICH score and ICH volume at the baseline. Conclusions:Early rise of NLR predicts 30-day mortality in patients with spontaneous ICH.

show abstract

Neutrophil-to-lymphocyte ratio and in-hospital mortality in patients with acute heart failure

Cited by 24 publications

References 30 publications

Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting Adverse Events in Elderly Patients With Chronic Heart Failure

Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting Adverse Events in Elderly Patients With Chronic Heart Failure

The neutrophil to lymphocyte ratio in heart failure: a comprehensive review

Early increase of neutrophil‐to‐lymphocyte ratio predicts 30‐day mortality in patients with spontaneous intracerebral hemorrhage

Contact Info

Product

Resources

About