Correlation Between Neutrophil to Lymphocyte Ratio and Myocardial Injury in Population Exposed to High Altitude

He, Siyi; He, Shengdong; Yang, Yongxiang; Li, Bin; Gao, Liang; Xie, Qingyun; Zhang, Lin

doi:10.3389/fcvm.2021.738817

Cited by 8 publications

(6 citation statements)

References 28 publications

(28 reference statements)

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“…Also, an AUC of 0.63 appears moderate for the prediction of overall CTR-CVT, but compared to other studies, investigating the association of NLR with cardiotoxicity under anti-cancer treatment similar values for AUC is reported [ 33 ]. The same applies to studies examining the association of NLR with mortality or myocardial injury in other non-cancer collectives [ 39 – 41 ].…”

Section: Discussionmentioning

confidence: 99%

High neutrophil-to-lymphocyte ratio is associated with cancer therapy-related cardiovascular toxicity in high-risk cancer patients under immune checkpoint inhibitor therapy

Haj-Yehia,

Mincu,

Korste

et al. 2023

Clin Res Cardiol

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Background Cancer therapy-related cardiovascular toxicity (CTR-CVT) from immune checkpoint inhibitor (ICI) therapy is still incompletely characterized, and patients with pre-existing cardiovascular disease represent a particularly high-risk cohort. Valid parameters for risk stratification of these patients are missing. Neutrophil-to-lymphocyte ratio (NLR) has been shown to predict mortality and adverse events in other cardiovascular cohorts. The present study aims to examine the predictive capacity of NLR for risk stratification of patients particularly vulnerable for CTR-CVT under ICI therapy. Methods We performed an analysis of 88 cancer patients (69 ± 11 years, 25% female) with pre-existing cardiovascular disease under ICI therapy from the prospective Essen Cardio-Oncology Registry (ECoR). NLR was assessed at patient enrollment and the population was divided through receiver operator characteristic (ROC) curve analysis in patients with low (< 4.57) and high (≥ 4.57) NLR. Endpoint was the whole spectrum of CTR-CVT, according to the European guidelines on cardio-oncology. The median follow-up was 357 days (interquartile range (IQR): 150–509 days). Results We observed 4 cases of myocarditis, 17 cases of vascular toxicity, 3 cases of arterial hypertension, 22 cases of arrhythmia or QTc prolongation and 17 cases of cardiovascular dysfunction. NLR was associated with overall CTR-CVT by univariable Cox regression (hazard ratio (HR): 1.443; 95% confidence interval (CI) 1.082–1.925; p = 0.013). However, this association was attenuated after adjusting for further confounders. Conclusion NLR is moderately associated with CTR-CVT in cancer patients with pre-existing cardiovascular disease under ICI therapy. Surveillance of NLR during ICI therapy might be an effective and economically biomarker for risk stratification in these high-risk patients. Graphical abstract

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Section: Discussionmentioning

confidence: 99%

High neutrophil-to-lymphocyte ratio is associated with cancer therapy-related cardiovascular toxicity in high-risk cancer patients under immune checkpoint inhibitor therapy

Haj-Yehia,

Mincu,

Korste

et al. 2023

Clin Res Cardiol

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“…Furthermore, we identified 11.415 10 9 /L as the cut-off value of NEU by ROC curve analysis. Notably, we tried to investigate the role of NLR, a valuable predictor of inflammation [ 20 , 21 ], in the diagnosis of muscle necrosis. NLR was found to be associated with muscle necrosis in univariate analysis, but it was not an independent risk factor based on logistic regression analysis.…”

Section: Discussionmentioning

confidence: 99%

Predictors of muscle necrosis in patients with acute compartment syndrome

Wang

Yang

Guo

et al. 2023

International Orthopaedics (SICOT)

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Purpose The predictors of muscle necrosis after acute compartment syndrome (ACS) remain debated. This study aimed to investigate the predictors for muscle necrosis in ACS patients. Methods We collected data on ACS patients following fractures from January 2010 to November 2022. Patients were divided into the muscle necrosis group (MG) and the non-muscle necrosis group (NG). The demographics, comorbidities, and admission laboratory indicators were computed by univariate analysis, logistic regression analysis, and receiver-operating characteristic (ROC) curve analysis. Results In our study, the rate of MN was 37.6% (83 of 221). Univariate analysis showed that numerous factors were associated with muscle necrosis following ACS. Logistic regression analysis indicated that crush injury ( p = 0.007), neutrophil (NEU, p = 0.001), creatine kinase myocardial band (CKMB, p = 0.047), and prothrombin time (PT, p = 0.031) were risk factors. Additionally, ROC curve analysis identified 11.415 10 9 /L, 116.825 U/L, and 12.51 s as the cut-off values for NEU, CKMB, and PT to predict muscle necrosis, respectively. Furthermore, the combination of NEU, CKMB, and PT had the highest diagnostic accuracy. Conclusions Our findings showed that crush injury and the level of NEU, CKMB, and PT were risk factors for muscle necrosis after ACS. Additionally, we also identified the cut-off values of NEU, CKMB, and PT and found the combination of crush injury, PT, and NEU with the highest diagnostic accuracy, helping us individualize the assessment risk of muscle necrosis to manage early targeted interventions.

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“…MI is a severe complication in population exposed to high altitude and may leads to malignant arrhythmias, heart failure, and even sudden death [6] . Our previous study found that the incidence of MI was as high as 33.2% in population transferring from high altitude [7] .…”

Section: Introductionmentioning

confidence: 94%

Clinical analysis of myocardial injury in highlanders with pulmonary hypertension

Zhao

Wu²,

Duanmu³

et al. 2023

Preprint

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Background: High altitude environment can give rise to Myocardial injury (MI) mainly because of hypoxia, where MI with pulmonary hypertension (PH) is one of the severe pathologies. In the present study, we intend to explore clinical characteristics of MI in patients with PH at high altitude and diagnostic value of various myocardial markers. Methods: Consecutive patients at the altitude of 3650m were selected into this retrospective study. Clinical and biochemical data were collected. According to the results of Cardiac troponin I (cTnI), patients were divided into MI group and non-MI group. Results: A total of 231 patients were enrolled in this study. MI occurred in 29 patients (12.6%). We found that body mass index (BMI, P=0.045), left ventricular end-diastolic dimension (LVEDD, P=0.005), and serum level of creatine kinase-MB (CK-MB, P=0.001) in MI group were significantly higher than that in non-MI group. Spearman correlation analysis revealed that cTnI have a significant positive correlation with CK-MB (P=0.000) and LDH (P <0.001) instead of aspartate aminotransferase (AST). A receiver operating characteristic (ROC) curve was drawn to demonstrate that CK-MB could significantly predict the occurrence of MI with an area under the curve (AUC) of 0.749 (P=0.000), and the level of 3.035 (sensitivity = 59.3%, specificity = 90.5%) was optimal cutoff value. Conclusion: The incidence of MI with PH is high in highlander. As a convenient and efficient marker, CK-MB is closely associated with cTnI and have a predict role in the occurrence of MI with PH under expose to high altitude hypoxia.

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Correlation Between Neutrophil to Lymphocyte Ratio and Myocardial Injury in Population Exposed to High Altitude

Cited by 8 publications

References 28 publications

High neutrophil-to-lymphocyte ratio is associated with cancer therapy-related cardiovascular toxicity in high-risk cancer patients under immune checkpoint inhibitor therapy

High neutrophil-to-lymphocyte ratio is associated with cancer therapy-related cardiovascular toxicity in high-risk cancer patients under immune checkpoint inhibitor therapy

Predictors of muscle necrosis in patients with acute compartment syndrome

Clinical analysis of myocardial injury in highlanders with pulmonary hypertension

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