Effect of cardiac rehabilitation on neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in ST elevation myocardial infarction patients

Abstract

Objectives: Cardiac rehabilitation is known to have positive effects on the inflammatory processes. The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) were found to be indicative of inflammation. The purpose of this study is to determine the effects of cardiac rehabilitation on the NLR and PLR ratios of ST elevation myocardial infarction (STEMI) patients. Methods: The study includes 101 STEMI patients that underwent primary percutaneous coronary intervention (PCI). The patients were randomized into two groups: the cardiac rehabilitation group (CR group, n = 68), and the control group (n = 33). One month after primary PCI, cardiac rehabilitation was applied to CR group with cycle ergometer for 8 weeks (30 sessions). The NLR and PLR parameters were calculated from the complete blood count results from before and after the cardiac rehabilitation application for both groups. Results: When the baseline values of the two groups were evaluated, the hemoglobin value of the control group (13.10 ± 1.52 g/dL vs. 13.79 ± 1.26 g/dL; p = 0.03) and the PLR value of the CR group (122.50 ± 43.89 vs. 92.41 ± 23.70; p = 0.001) were significantly higher. The post-cardiac rehabilitation complete blood count parameters, and the NLR and PLR values were similar in both groups. The NLR (3.11 ± 1.95 vs 2.39 ± 1.03; p = 0.003) and PLR (122.50 ± 43.89 vs. 108.68 ± 41.83; p = 0.025) parameters significantly decreased after the cardiac rehabilitation application in the CR group, whereas there wasn't a change in the control group. Conclusion: It was found that cardiac rehabilitation applied in STEMI patients caused a significant decrease in NLR and PLR parameters, which are indicators of inflammation.

Effects of cardiac rehabilitation on inflammatory biomarkers in unstable ischemic heart disease patients following percutaneous coronary intervention: a randomized controlled study

“…A recent study found that after a 30-session rehabilitation program among cardiac patients, CRP level, neutrophil count, platelet count, and the ratio of NLR and PLR decreased significantly; however, the change in lymphocyte count was not statistically significant [12]. Another recent study found that the levels of leukocytes, neutrophils, NLR, and PLR diminished significantly after 8 weeks of rehabilitation among STEMI patients (ST-segment elevation MI) in the CR group [10].…”

“…After rehabilitation was applied to the CR group, the difference between the two groups was NS anymore. They reported that NLR and PLR parameters significantly decreased after 30 sessions of CR in the CR group, while it was not the case with the control group [10]. Another study revealed that a 6-week CR program brought about a significant reduction in hs-CRP levels among acute coronary syndrome patients [21].…”

“…We calculated the sample size according to Zengin et al . study on NLR reduction for detection of a mean reduction of 1.35 ± 0.75 in the intervention group and 1 ± 0.2 in the control group [10]. We calculated a sample of 114 patients (76 in the intervention and 38 in the control group for a 2 : 1 randomization ratio) would be required to achieve 80% power.…”

Effect of cardiac rehabilitation on mortality related inflammatory markers

“…They are also related to the non-dipper status of the hypertensive patients, resulting in more cardiovascular complications [4,[6][7][8][9]17]. In a recent study, Fest et al [18] followed up 8715 individuals for 12 years (2002-2014) to assess NLR association with mortality in the general population and concluded that NLR is a strong and independent risk factor for mortality in elderly population.…”