Association of Lymphocyte-to-Monocyte Ratio With the Mortality in Patients With ST-Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention

Abstract

We investigated whether the lymphocyte-to-monocyte ratio (LMR) 48 hours after admission is related to 30-day and long-term mortality in patients with ST-elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention (PCI). We evaluated 318 consecutive patients with STEMI who were undergoing primary PCI. The relationship between the LMR and all-cause mortality (30-day and long-term) was analyzed by categorizing the patients into tertiles (T) according to LMR-T1 (>2.46), T2 (1.67-2.46), and T3 (<1.67). The T3 group exhibited the highest risk of 30-day all-cause mortality (hazard ratio [HR]: 8.093 [1.006-65.074]; P = .049). For long-term mortality, a significantly higher mortality risk was observed in both T2 (HR: 2.005 [1.021-3.939]; P = .043) and T3 groups (HR: 2.374 [1.160-4.857]; P < .001) compared to the T1 group (reference group). In multivariate analysis, these associations remained unaltered even after adjusting for confounders. A low LMR at 48 hours after admission may be independently associated with both 30-day and long-term mortality in patients with STEMI who were treated with primary PCI. This marker may be used for identifying patients with STEMI at high risk.

Sex differences in leukocyte profile in ST-elevation myocardial infarction patients

“…In our study we showed that higher LMR was associated with smaller infarct size (biochemical and functional) and lower mortality. This is in accordance with previous literature, which found that a low LMR at 48 hours after admission was independently associated with both an increased short-and long-term mortality in STEMI patients 22 . It has been hypothesized that the association of lower LMR with higher mortality is due to an elevation of serum catecholamines and cortisol levels during a systemic stress response, resulting in lymphocyte apoptosis.…”

“…This reflects a suppressed immune system. Others speculate on down-regulation of lymphocyte proliferation and differentiation, and lymphocyte redistribution within the lymphopoietic systems 22 .…”

The association of neutrophil-lymphocyte ratio and lymphocyte-monocyte ratio with 3-month clinical outcome after mechanical thrombectomy following stroke

“…Indeed, among patients with acute myocardial infarction, it has been shown that an increased NLR is a predictor of in-hospital mortality and morbidity [26], and impaired myocardial perfusion after percutaneous coronary angioplasty [27]. Similarly, LMR has been reported to be associated with adverse prognosis in multiple malignancies [22,28] and coronary artery disease [21,29].…”

The predictive value of lymphocyte-to-monocyte ratio in the prognosis of acute coronary syndrome patients: A systematic review and meta-analysis

“…The result showed that LMR predicted short-term mortality/MACE (HR = 3.44, 95% CI: 1.46-8.14, P < 0.05, Figure 2A), with low levels of heterogeneity among studies (I 2 = 0%). The combined analysis of 5 studies covering 4343 patients described the relationship between LMR and longterm mortality/MACE [18,[21][22][23][24]. The pooled outcome for low LMR value compared with high LMR value group was found to be 1.70 (95% CI: 1.36-2.13, P < 0.05, Figure 2B), with moderate levels of heterogeneity among studies (I 2 = 46.8%).…”

“…Others were de ned as long-term. The combined analysis of 2 studies covering 1281 patients described the relationship between LMR and short-term mortality/MACE [21,23]. The result showed that LMR predicted short-term mortality/MACE (HR = 3.44, 95% CI: 1.46-8.14, P < 0.05, Figure 2A), with low levels of heterogeneity among studies (I 2 = 0%).…”