Does Absolute Neutrophilia Predict Early Congestive Heart Failure After Acute Myocardial Infarction? A Cross-Sectional Study

Objective:We aimed to study the predictive value of the neutrophil-lymphocyte ratio (NLR) for left ventricular systolic dysfunction (LVSD) in patients with non ST-elevated acute coronary syndrome (NST-ACS).Methods:A total of 405 patients (mean age 62 years and 75% male) with NST-ACS were included in the study. The study population was divided into tertiles based on admission NLR values. The low, medium and high tertiles defined as NLR≤1.81 (n=135), 1.813.2 (n=135), respectively.Results:The patients in the high NLR group were older (p<0.001), have higher rate of diabetes mellitus (p=0.028) and non-ST elevated myocardial infarction (NSTEMI) (p<0.001) and have lower left ventricular ejection fraction (LVEF) (p<0.001). Baseline WBC (p=0.02) and neutrophil (p<0.001) levels and NLR (p<0.001) were significantly higher, baseline hemoglobin (p=0.044), hematocrit (p=0.019) and lymphocyte (p<0.001) levels were significantly lower in the high NLR group. NLR was negatively correlated with LVEF in correlation analysis. An NLR >3.2 and age ≥70 were found to be an independent predictor of systolic dysfunction in multivariate analyses.Conclusion:An NLR >3.2 is a useful predictor for LVSD in patients with NST-ACS. The practice of using an NLR count on admission may be useful for identifying high-risk patients and their associated treatment methods.

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“… 13 Recent studies have shown advanced HF after MI and mortality were higher in patients with a higher neutrophil count. 14 …”

Section: Discussionmentioning

confidence: 99%

Predictive value of elevated neutrophil-lymphocyte ratio for left ventricular systolic dysfunction in patients with non ST-elevated acute coronary syndrome

et al. 2014

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“…Clinically, inflammatory and immune circulatory cells, including neutrophils, platelets, and lymphocytes, have pivotal roles in development of heart disease [3–5]. As suggested in cross-sectional research, neutrophilic granulocytosis in the early stage of AMI can increase the risk of subsequent congestive heart failure [6]. Higher platelet counts reflect increased thrombocyte activation, aggravate release of inflammatory mediators, and the undesirable inflammatory process [7].…”

Section: Introductionmentioning

confidence: 99%

Systemic Immune-Inflammatory Index Predicts Clinical Outcomes for Elderly Patients with Acute Myocardial Infarction Receiving Percutaneous Coronary Intervention

et al. 2019

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BackgroundWe assessed the utility of the systemic immune-inflammatory index (SII) in estimating the in-hospital and long-term prognosis of elderly patients with acute myocardial infarction (AMI) who received percutaneous coronary intervention (PCI).Material/MethodsOur study evaluated 711 consecutive elderly patients (age 65–85 years) from January 2015 to December 2017. The correlation between clinical outcomes and SII was analyzed through the stepwise Cox regression analysis and the Kaplan-Meier approach. The clinical endpoints were all-cause mortality and major adverse cardiovascular and cerebrovascular events (MACCE) in-hospital and during 3-year follow-up.ResultsThe study enrolled 711 elderly patients with AMI (66.95% male, 71.99±0.19 years). Kaplan-Meier analysis showed a lower survival rate in patients with higher SII scores, which also predicted in-hospital and long-term (≤3 years) outcomes. In multivariate analyses, SII showed an independent predictive value for in-hospital mortality (hazard ratio (HR), 3.32; 95% confidence interval (CI), 1.55–7.10; p<0.01), in-hospital MACCE (HR, 1.43; 95%CI, 1.02–2.00; p=0.04), long-term mortality (HR, 1.95; 95%CI, 1.23–3.09; p<0.01), along with long-term MACCE (HR, 1.72; 95%CI, 1.23–2.40; p<0.01). Moreover, SII showed a weak but significant positive relationship with the Gensini score among patients developing non-ST-segment elevation myocardial infarction (r=0.18; p<0.01).ConclusionsSII, a readily available laboratory marker, is a potential indicator to predict the clinical endpoints for elderly patients with AMI undergoing PCI.

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“…The effect of neutrophils on myocardial function after MI and its effects on early postmyocardial infarction CHF have been studied [13]. Neutrophils and macrophages can cause myocardial reperfusion injury [14].…”

Section: Discussionmentioning

confidence: 99%

“…Increase WBC count was associated with poorer prognosis after CABG but this association was not related to the other parameters such as hematocrit or platelet count. There are some studies which have described the role of CRP in direct vascular injury as a preinflammatory and prothrombotic factor, mainly through activating tissue factors [13] and stimulation of TNF, IL6, and IL2 [21]. Overall, it is not clear whether higher levels of acute phase reactants are directly involved in vascular injury or they are just markers of poor prognosis after CABG and this is the subject of debate.…”

Section: Discussionmentioning

confidence: 99%

Is Leukocytosis a Predictor for Recurrence of Ischemic Events after Coronary Artery Bypass Graft Surgery? A Cohort Study

et al. 2012

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Objective. Studies have shown that inflammation plays an important role in pathogenesis of coronary artery disease. The present study was designed to evaluate the role of high WBC count before CABG in predicting the risk of ischemic events after CABG. Methods and Results. This prospective study was carried out on 380 patients who underwent CABG surgery. Ninety seven patients (25.5%) had recurrent ischemic event. Mean WBC count before CABG surgery in patients with recurrent ischemic event was 7267 mic/lit ± 1863, which was significantly higher than the others, with a mean WBC count of 6721 mic/lit ± 1734 (P = 0.011). Patients with a WBC count more than 6000 mic/lit were at the highest risk for recurrent ischemic event (OR = 2.11, 95% CI = 1.18–3.44, P = 0.009). After adjustment for age, sex, family history, smoking, hyperlipidemia, Logestic Euro score, post opretive enzyme release (CK.mb), arterial graft and BMI, the relationship between the group with WBC count higher than 6000 mic/lit and recurrent of ischemic event remained significant (OR = 2.25, 95% CI = 1.2 to 4, P = 0.005). Conclusions. High WBC count before CABG surgery is an independent risk factor for ischemic events one year after the surgery.

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Does Absolute Neutrophilia Predict Early Congestive Heart Failure After Acute Myocardial Infarction? A Cross-Sectional Study

Abstract: The study shows that the presence of absolute neutrophilia during the first 12 hours after AMI can predict the occurrence of CHF. This association may help identify high-risk individuals, who might benefit from more aggressive interventions.

Cited by 20 publications

References 36 publications

Predictive value of elevated neutrophil-lymphocyte ratio for left ventricular systolic dysfunction in patients with non ST-elevated acute coronary syndrome

Predictive value of elevated neutrophil-lymphocyte ratio for left ventricular systolic dysfunction in patients with non ST-elevated acute coronary syndrome

Systemic Immune-Inflammatory Index Predicts Clinical Outcomes for Elderly Patients with Acute Myocardial Infarction Receiving Percutaneous Coronary Intervention

Is Leukocytosis a Predictor for Recurrence of Ischemic Events after Coronary Artery Bypass Graft Surgery? A Cohort Study

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