Increased neutrophil-to-lymphocyte ratio predicts persistent coronary no-flow after wire insertion in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

Kurtul, Alparslan; Murat, Sani Namık; Yarlıoğlueş, Mikail; Duran, Mustafa; Çelik, İbrahim Etem; Kılıç, Alparslan; Öcek, Adil Hakan

doi:10.6061/clinics/2015(01)07

Cited by 18 publications

(15 citation statements)

References 27 publications

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“…With the growing understanding of the pathophysiological mechanisms, neutrophil-platelets are thought to be activated to exaggerate inflammatory cascade reaction by releasing mediators, radical oxygen, and to aggregate to block the coronary lumen, deteriorating microvascular perfusion after restoring the blood flow of the culprit vessel. Among all the routine blood indexes, NLR has been confirmed as the most significantly independent parameter of CMVO [29,30], which is consistent with the present study findings.…”

Section: Discussionsupporting

confidence: 92%

Development and Validation of Risk Nomogram Model Predicting Coronary Microvascular Obstruction in Patients with ST-Segment Elevation Myocardial Infarction (STEMI) Undergoing Primary Percutaneous Catheterization

Xiao

Wang

et al. 2019

Med Sci Monit

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Background Coronary microvascular functional and structural obstruction (CMVO) remains a major complication in patients with ST-segment elevation myocardial infarction (STEMI). This study was designed to develop and validate a nomogram model to predict CMVO risk during primary percutaneous catheterization procedure. Material/Methods Starting January 2014 to December 2016, a cohort of eligible candidates were enrolled and divided into a training or a validation database. Each database was divided into MO or NMO subgroups based on TIMI myocardial perfusion grade results after recanalization. Independent factors were identified by multivariate logistic regression, from which the nomogram was plotted. The echocardiography measurement of the left ventricular ejection fraction (LVEF) was arranged within 7 days after the procedure. Results A nomogram was built for CMVO risk prediction for the first time. There were 446 participants in the training database with 319 cases in the NMO subgroup and 127 participants in the MO subgroup. The validation database included 99 participants with 25 cases in the NMO subgroup and 74 in the MO subgroup. The risk model was developed by 6 independently significant factors: age, symptom onset to balloon time, Killip classification, admission activated clotting time, neutrophil/lymphocyte ratio, and glucose value. Internal receiver operating characteristic displayed favorable performance with concordance index of 0.925, while external validation area under curve was 0.939. There were significant differences in LVEF values during hospitalization between the subgroups of each database (both P <0.001). Conclusions The nomogram model consisting of 6 factors could predict CMVO risk accurately for STEMI patients undergoing primary percutaneous catheterization.

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Section: Discussionsupporting

confidence: 92%

Development and Validation of Risk Nomogram Model Predicting Coronary Microvascular Obstruction in Patients with ST-Segment Elevation Myocardial Infarction (STEMI) Undergoing Primary Percutaneous Catheterization

Xiao

Wang

et al. 2019

Med Sci Monit

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“…NLR has been recently studied as a potential biomarker to determine inflammation in cardiac and noncardiac disorders including coronary artery disease, gastrointestinal diseases, and malignancies [18][19][20]. NLR elevation has also been associated with poor prognosis in acute coronary syndromes and stable coronary heart diseases [21,22]. It has been shown to be a more effective predictor of inflammation than leukocyte levels [23].…”

Section: Discussionmentioning

confidence: 99%

Novel hematologic inflammatory parameters to predict acute mesenteric ischemia

Toptaş

Akkoç

Savas

et al. 2016

Blood Coagulation &Amp; Fibrinolysis

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Acute mesenteric ischaemia (AMI) is an emergency condition that requires urgent diagnosis. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have been studied as inflammatory biomarkers in atherosclerosis, but data regarding AMI are lacking. The study population included patients with AMI (n = 46) versus age and sex-matched healthy controls (n = 46). Computed multidetector tomographic angiography was performed to diagnose AMI. NLR and PLR were calculated using complete blood count. C-reactive protein (CRP) levels were also analyzed. Neutrophil levels and lymphocytes were significantly higher in patients with AMI than in the control individuals (P < 0.001 and P = 0.43, respectively). NLR levels were significantly higher in patients with AMI compared with that in the control individuals (P < 0.001). Platelet levels did not reach statistical significance between the groups (P = 0.709). However, patients with AMI had significantly higher PLR levels than the control group (P = 0.039). CRP levels on admission were higher in patients with AMI in comparison with control individuals. There was also a positive correlation between NLR and CRP (r = 0.548, P < 0.001), and between PLR and CRP (r = 0.528, P < 0.001). NLR level greater than 4.5, measured on admission, yielded an area under the curve value of 0.790 (95% confidence interval 0.681-0.799, sensitivity 77%, specificity 72%), and PLR level of greater than 157 yielded an area under the curve value of 0.604 (95% confidence interval 0.486-0.722, sensitivity 59%, specificity 65%). Patients with AMI had increased NLR, PLR, and CRP levels compared with controls. Increased NLR and PLR was an independent predictor of AMI.

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“…Accumulating evidence has demonstrated the strong link between high NLR and increased morbidity and mortality in a wide range of cardiovascular diseases, including acute coronary syndrome. 25 , 26 , 27 , 28 , 29 , 30 In this study, we have analysed the data retrospectively from 715 patients who underwent PCI 72 hours from onset. Our results showed that NLR was strongly associated with myocardial damage (CK-mB) and negatively associated with cardiac contractility (EF and FS).…”

Section: Discussionmentioning

confidence: 99%

Neutrophil to lymphocyte ratio as a predictor of myocardial damage and cardiac dysfunction in acute coronary syndrome patients

Chen

Cong

Wang

et al. 2018

Integrative Medicine Research

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BackgroundNeutrophil to lymphocyte ratio (NLR) in peripheral blood is established to correlate with the morbidity and mortality of heart disease patients. We aimed to define the severity of inflammation (NLR) by observing the association of NLR with cardiac functions or myocardial damage parameters in patients with acute myocardial infarction.MethodsData from 715 patients who underwent percutaneous coronary intervention (PCI) within 72 hours of incidence in 2016 were analysed retrospectively.ResultsThe NLR ranges from 0.50 to 46 (medium ± SD, 2.76 ± 2.96) in 715 patients. NLR positively correlated with myocardial damage (NLR vs. CK-mB: p < 0.0001) but negatively correlated with myocardial function (NLR vs. EF: p < 0.0001; NLR vs. FS: p < 0.0001). Myocardial damage markers (CK, CK-mB, ASL, LDH) were significantly increased, and cardiac contractile parameters (EF and FS) were reduced at NLR > 2.76 compared to those of NLR < 2.76. ELISA analysis has shown that IL-10 was significantly increased when NLR ≥ 4.6 and TGF-β was increased at NLR > 4. The correlation was diminished between NLR and CK-mB at NLR > 2.76 or at NLR > 4, but that of NLR and EF or FS was maintained in NLR > 2.76 and at NLR > 4. EF and FS were comparable between NLR > 2.76 and NLR > 4. But myocardial damage parameters increased significantly at NLR > 4 compared to those of NLR > 2.76.ConclusionNLR is a strong predictor of myocardial damage in acute myocardial patients. High NLR are associated with myocardial dysfunction in all the patients. Severe inflammation (NLR) can predict the consequence of the heart in patients with coronary syndrome.

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Increased neutrophil-to-lymphocyte ratio predicts persistent coronary no-flow after wire insertion in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

Cited by 18 publications

References 27 publications

Development and Validation of Risk Nomogram Model Predicting Coronary Microvascular Obstruction in Patients with ST-Segment Elevation Myocardial Infarction (STEMI) Undergoing Primary Percutaneous Catheterization

Development and Validation of Risk Nomogram Model Predicting Coronary Microvascular Obstruction in Patients with ST-Segment Elevation Myocardial Infarction (STEMI) Undergoing Primary Percutaneous Catheterization

Novel hematologic inflammatory parameters to predict acute mesenteric ischemia

Neutrophil to lymphocyte ratio as a predictor of myocardial damage and cardiac dysfunction in acute coronary syndrome patients

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