Elevated neutrophil-to-lymphocyte ratio can predict procedural adverse events in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

Machado, Guilherme Pinheiro; Araújo, Gustavo Neves de; Carpes, Christian Kunde; Lech, Mateus Correa; Mariani, Stéfani; Valle, Felipe Homem; Bergoli, Luiz Carlos Corsetti; Wainstein, Rodrigo Vugman; Wainstein, Marco Vugman

doi:10.1097/mca.0000000000000671

Cited by 11 publications

(7 citation statements)

References 22 publications

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“…respectively. Out of 35 observational studies, there were 34 retrospective or prospective studies [12–45] and 1 cross-sectional study. [46] These 35 observational studies enrolled a total population of 28,756 participants, out of which 9678 patients had high NLR and 13,105 patients had low NLR, while one study didn’t specify high NLR and low NLR participants.…”

Section: Resultsmentioning

confidence: 99%

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Neutrophil to lymphocyte ratio as a prognostic marker for cardiovascular outcomes in patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention: A systematic review and meta-analysis

Ul Hussain,

Kumar,

Zahid

et al. 2024

Medicine

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Background: Neutrophil to lymphocyte ratio (NLR) has been considered a prognostic biomarker of mortality and other major cardiac events. This study investigates NLR’s efficacy in predicting in-hospital and long-term outcomes in patients with ST-segment elevated myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). Methods: Electronic databases (PUBMED, Cochrane CENTRAL, ERIC, Embase, Ovid, and Google Scholar) were searched till June 2022 to identify studies having STEMI patients who underwent PCI. Risk ratios and mean differences (MDs), along with their corresponding 95% confidence intervals (Cis) and standard deviations (SDs), were pooled using a random-effect model. This meta-analysis has been registered on Prospero (ID: CRD42022344072). Results: A total of 35 studies with 28,756 patients were included. Pooled estimates revealed an increased incidence of primary outcomes; in-hospital all-cause mortality (RR = 3.52; 95% CI = 2.93–4.24), long-term all-cause mortality (HR = 1.07; 95% CI = 1.00–1.14), (RR = 3.32; 95% CI = 2.57–4.30); in-hospital cardiovascular mortality (RR = 2.66; 95% CI = 2.04–3.48), long-term cardiovascular mortality (RR = 6.67; 95% CI = 4.06–10.95); in-hospital major adverse cardiovascular events (MACE) (RR = 1.31; 95% CI = 1.17–1.46), long-term MACE (RR = 2.92; 95% CI = 2.16–3.94); length of hospital stay (WMD = 0.60 days; 95% CI = 0.40–0.79) in patients with high NLR compared to those with a low NLR. Conclusion: NLR might be a valuable tool for prognostication (in-hospital) and stratification of patients with STEMI who underwent PCI.

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Section: Resultsmentioning

confidence: 99%

“…(HR = 1.29; 95% CI = 1.08-1.56; P = .006; I 2 = 86%), (RR = 3.12; 95% CI = 2.31-4.22; P < .00001; I 2 = 71%). Sensitivity analysis was performed by removing 2 [12,43] and 3 studies [13,37,41] Figure 1. PUBMED relevance keywords map.…”

Section: All-cause Mortalitymentioning

confidence: 99%

Neutrophil to lymphocyte ratio as a prognostic marker for cardiovascular outcomes in patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention: A systematic review and meta-analysis

Ul Hussain,

Kumar,

Zahid

et al. 2024

Medicine

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“…In a previous study, 664 patients were treated with ST-segment elevation for emergency PCI, and the high NLR group (≥9.45) was associated with MACE during hospitalization. 15 Preoperative NLR is related to the occurrence of MACE in patients with acute myocardial infarction within 1 year after PCI. 16 , 17 Moreover, a predictive value for MACE was found 5 years after elective PCI in patients with stable coronary heart disease.…”

Section: Discussionmentioning

confidence: 99%

Correlation of neutrophil-to-lymphocyte ratio with the prognosis of non-ST-segment elevation in patients with acute coronary syndrome undergoing selective percutaneous coronary intervention

Wang

Cao

et al. 2020

J Int Med Res

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Objective We aimed to explore the relationship between neutrophil-to-lymphocyte ratio (NLR) at three timepoints and prognosis of patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) undergoing elective percutaneous coronary intervention (PCI) within 1 year of PCI. Methods This retrospective study enrolled 231 patients with NSTE-ACS who received PCI and were followed for 1 year after PCI. The study population was divided into major adverse cardiovascular and cerebrovascular events (MACE) and non-MACE groups. Results In total, 214 patients completed the 1-year follow-up; 32 patients (15.0%) had MACE and 182 (85.0%) had no MACE. The MACE and non-MACE groups differed significantly in age, preoperative neutrophil count, preoperative and postoperative NLR, proportion of three-vessel lesion disease, preoperative lymphocyte count, postoperative lymphocyte count within 24 hours, postoperative lymphocyte count over 24 hours, and left ventricular ejection fraction (LVEF). Multivariate logistic regression analysis showed that preoperative NLR, postoperative NLR within 24 hours, age, and LVEF values were independent risk factors for MACE in patients with NSTE-ACS after elective PCI. Conclusion Compared with preoperative NLR, postoperative NLR (within 24 hours) may have a stronger ability to predict the occurrence of MACE in NSTE-ACS patients within 1 year after elective PCI.

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“…Inflammatory cells in peripheral blood mainly include neutrophils, monocytes, platelets, and lymphocytes. Previous studies have shown that neutrophils, 6 – 8 monocytes, 9 – 11 and platelets 12 , 13 may promote development of atherosclerosis, whereas lymphocytes may inhibit atherosclerosis. 14 – 17 The ratios of pro-atherosclerotic inflammatory cells to anti-atherosclerotic inflammatory cells, the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR), may provide more information than a single inflammatory cell level.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of peripheral blood inflammatory cell subsets in patients with acute coronary syndrome undergoing percutaneous coronary intervention

et al. 2021

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Objective This study aimed to investigate the predictive value of inflammatory cells in peripheral blood on the prognosis of patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Methods Patients (n=1558) were consecutively enrolled and the median follow-up was 1142 days. Patients were divided into the major adverse cardiac events (MACE) 1 group (n=63) (all-cause mortality [n=58] and rehospitalization for severe heart failure [n=5], no MACE1 group (n=1495), MACE2 group (n=38) (cardiac mortality [n=33] and rehospitalization for severe heart failure [n=5]), and no MACE2 group (n=1520). The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) were analyzed. Results The NLR, MLR, and PLR were higher in the MACE groups than in the no MACE groups. Different subsets of inflammatory cells had similar diagnostic values for MACE. Kaplan–Meier curves showed that the survival time gradually decreased with an increase in the degree of risk as determined by the NLR, MLR, and PLR. The risk of MACE was highest in the extremely high-risk group. Conclusion Peripheral blood inflammatory cell subsets can predict MACE in patients with ACS undergoing PCI. These cell subsets could be important laboratory markers for the prognosis and clinical treatment of these patients.

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Elevated neutrophil-to-lymphocyte ratio can predict procedural adverse events in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

Cited by 11 publications

References 22 publications

Neutrophil to lymphocyte ratio as a prognostic marker for cardiovascular outcomes in patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention: A systematic review and meta-analysis

Neutrophil to lymphocyte ratio as a prognostic marker for cardiovascular outcomes in patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention: A systematic review and meta-analysis

Correlation of neutrophil-to-lymphocyte ratio with the prognosis of non-ST-segment elevation in patients with acute coronary syndrome undergoing selective percutaneous coronary intervention

Prognostic value of peripheral blood inflammatory cell subsets in patients with acute coronary syndrome undergoing percutaneous coronary intervention

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