Changes in the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios before and after percutaneous coronary intervention and their impact on the prognosis of patients with acute coronary syndrome

Sheng, Jian‐Zhong; Liu, Nina; He, Fei; Cheng, Cheng; Shen, Shichun; Sun, Yuting

doi:10.6061/clinics/2021/e2580

Cited by 12 publications

(9 citation statements)

References 29 publications

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“…Simultaneously, NLR increased significantly the day after admission ( Figure 3 ). In this case, the NLR recorded the day after admission was 11, notably higher than the reported average NLR of 4.5 within the first 24 h following AMI [ 21 ]. As PCI can also cause an inflammatory response, a marked increase in CRP level and NLR on the day after revascularization can be a good indicator of the early detection of mechanical complications [ 22 ].…”

Section: Discussionmentioning

confidence: 59%

Anterolateral Papillary Muscle Rupture Predicted by Post-Infarction Inflammatory Markers

2023

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Patient: Female, 72-year-old Final Diagnosis: Anterolateral papillary muscle rupture Symptoms: Discomfort • nausea • sweating Clinical Procedure: — Specialty: Cardiology • Genetics Objective: Rare coexistence of disease or pathology Background: The incidence of papillary muscle rupture (PMR), a mechanical complication of acute myocardial infarction, has decreased in the reperfusion era; however, its fatality rate remains high. Timely recognition and prompt initiation of treatment for PMR are important to avoid prolonged cardiogenic shock; however, the symptoms of PMR are nonspecific, and early diagnosis is often difficult. Case Report: A 72-year-old woman with nausea for 2 days presented with ST-segment elevation myocardial infarction with obstruction of the obtuse marginal branch and 75% stenosis of the first diagonal branch. Percutaneous coronary intervention was performed to revascularize the obtuse marginal lesion, which was over thrombolysis in myocardial infarction grade 2 flow. After percutaneous coronary intervention, the patient developed fever, an elevated C-reactive protein level, and an increased neutrophil-to-lymphocyte ratio (NLR). The patient showed no signs of infection but elevated inflammatory marker levels, with C-reactive protein rising to 39.32 mg/dL and NLR to 15. On postoperative day 4, the patient’s clinical condition rapidly deteriorated, resulting in circulatory failure. Transthoracic echocardiography showed anterolateral PMR, and urgent surgical mitral valve replacement was performed. On day 32, the patient was discharged from the hospital, and at the 1-year follow-up, she remained in good health. Conclusions: When there are multiple lesions, including the obtuse marginal and diagonal branches, anterolateral PMR should be suspected as the cause of cardiogenic shock. Performing point-of-care echocardiography and closely monitoring C-reactive protein levels and NLR can be helpful to detect PMR early.

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Section: Discussionmentioning

confidence: 59%

Anterolateral Papillary Muscle Rupture Predicted by Post-Infarction Inflammatory Markers

2023

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“…Sheng et al found that the neutrophil count and proportion at 24 hours after PCI in patients with ACS were significantly higher than those before PCI, while platelet and lymphocyte counts were significantly decreased. 33 Additionally, a recent study also reported that the absolute counts of neutrophils, intermediate monocytes and CD4 + (helper) T cells were significantly increased in the depressed group. 34 In view of that decreased lymphocyte and increased neutrophil count are both found in post-PCI patients and depression subjects, which might partly explain the increased NLR levels observed in post-PCI depression patients.…”

Section: Discussionmentioning

confidence: 94%

Higher Neutrophil to Lymphocyte Ratio at Admission is Association with Post-PCI Depressive Symptoms in Patients with ACS

Li¹,

Wan²,

Li³

et al. 2022

NDT

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Background: Depression and elevated blood biomarkers of inflammation are common in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). Neutrophil to lymphocyte ratio (NLR) is an indicator of peripheral inflammation and has been proved to be associated with both ACS and depression. Purpose: Our aim was to evaluate the possible association between NLR at admission and post-PCI depressive symptoms at 1 month. Patients and Methods: A total of 224 patients with ACS who underwent PCI for the first time were recruited and completed 1-month follow-up. The 24-item Hamilton Depression Scale (HAMD-24) was used to measure depressive symptoms at 1 month after PCI. Logistic regression was used to analyze the relationship between different NLR levels and post-PCI depressive symptoms. A receiver operating characteristic (ROC) curve analysis was performed to assess the value of NLR for predicting post-PCI depressive symptoms and to determine its critical value. Results: Of the 224 enrolled patients, 52 (23.2%) patients were diagnosed with depressive symptoms at 1 month after PCI. Patients with depressive symptoms showed significantly higher level of NLR at admission than patients without depressive symptoms (4.33 (3.26, 7.01) vs 2.57 (1.72, 3.91), P < 0.001). The proportion of depressive symptoms in post-PCI patients increases progressively along with NLR quartile. In the results of multivariate-adjusted logistic regression analysis, the odds ratio (OR) of post-PCI depressive symptoms was 12.028 (95% CI, 2.642-54.752) for the lowest quartile of NLR compared with the highest quartile. According to the receiver operating characteristic curve (ROC), the area under the curve (AUC) for predicting post-PCI depressive symptoms was 0.716 (95% CI, 0.641-0.791; P < 0.001), and the optimal cutoff of NLR levels was 3.235 (sensitivity: 76.9%, specificity: 66.9%). Conclusion:Higher NLR levels at admission were associated with post-PCI depressive symptoms at 1 month, suggesting that NLR might be useful inflammatory markers to predict post-PCI depressive symptoms at 1 month.

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“…The analysis of the receiver operating characteristic (ROC) curve indicated that the NLR measured at 24 h after PCI demonstrated superior predictive ability for the occurrence of MACE. There was a significant correlation observed between the NLR at 24 h after PCI and the quantity and length of stents implanted, as well as the duration of the procedure [ 23 ].…”

Section: Resultsmentioning

confidence: 99%

“…The number and length of stents inserted, the duration of the operation, were significantly correlated with the NLR at 24 h following PCI, increasing the risk of recurrent ischemic episodes [ 19 , 20 , 23 ].…”

Section: Figurementioning

confidence: 99%

Assessment of Inflammatory Hematological Ratios (NLR, PLR, MLR, LMR and Monocyte/HDL–Cholesterol Ratio) in Acute Myocardial Infarction and Particularities in Young Patients

Tudurachi,

Anghel,

Tudurachi

et al. 2023

IJMS

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Cardiovascular disease, particularly coronary artery disease (CAD), remains a predominant cause of mortality globally. Factors such as atherosclerosis and inflammation play significant roles in the pathogenesis of CAD. The nexus between inflammation and CAD is underscored by the role of immune cells, such as neutrophils, lymphocytes, monocytes, and macrophages. These cells orchestrate the inflammatory process, a core component in the initiation and progression of atherosclerosis. The activation of these pathways and the subsequent lipid, fibrous element, and calcification accumulation can result in vessel narrowing. Hematological parameters derived from routine blood tests offer insights into the underlying inflammatory state. Recent studies have highlighted the potential of inflammatory hematological ratios, such as the neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, monocyte/lymphocyte ratio and lymphocyte/monocyte ratio. These parameters are not only accessible and cost-effective but also mirror the degree of systemic inflammation. Several studies have indicated a correlation between these markers and the severity, prognosis, and presence of CAD. Despite the burgeoning interest in the relationship between inflammatory markers and CAD, there remains a paucity of data exploring these parameters in young patients with acute myocardial infarction. Such data could offer valuable insights into the unique pathophysiology of early-onset CAD and improve risk assessment and predictive strategies.

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Changes in the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios before and after percutaneous coronary intervention and their impact on the prognosis of patients with acute coronary syndrome

Cited by 12 publications

References 29 publications

Anterolateral Papillary Muscle Rupture Predicted by Post-Infarction Inflammatory Markers

Anterolateral Papillary Muscle Rupture Predicted by Post-Infarction Inflammatory Markers

Higher Neutrophil to Lymphocyte Ratio at Admission is Association with Post-PCI Depressive Symptoms in Patients with ACS

Assessment of Inflammatory Hematological Ratios (NLR, PLR, MLR, LMR and Monocyte/HDL–Cholesterol Ratio) in Acute Myocardial Infarction and Particularities in Young Patients

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