Neutrophil to lymphocyte ratio and future risk of venous thromboembolism and mortality: the Tromso Study

Grimnes, Gro; Horvei, Lars D.; Tichelaar, Vladimir; Brækkan, Sigrid Kufaas; Hansen, John‐Bjarne

doi:10.3324/haematol.2016.145151

Cited by 21 publications

(23 citation statements)

References 15 publications

(20 reference statements)

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“… 10 We found a similar time-dependent pattern between another inflammation marker, the neutrophil to lymphocyte ratio (NLR), and VTE risk in the Tromsø study cohort. 11 There was no association between NLR and risk of VTE after a median follow-up time of 17.7 years, but when follow-up time was restricted to the first 3 years, those with the highest baseline NLR had a 2.4-fold increased risk of VTE. Taken together, these studies suggest that acute and augmented inflammation rather than longstanding, low-grade inflammation is associated with VTE risk.…”

Section: Discussionmentioning

confidence: 79%

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C-reactive protein and risk of venous thromboembolism: results from a population-based case-crossover study

et al. 2018

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Long-term, low-grade inflammation does not seem to be a risk factor for venous thromboembolism. The impact of acute inflammation, regardless of cause, on risk of venous thromboembolism is scarcely studied. We aimed to investigate the impact of acute inflammation, assessed by C-reactive protein, on short-term risk of venous thromboembolism. We conducted a case-crossover study of patients with venous thromboembolism (n=707) recruited from a general population. Information on triggers and C-reactive protein levels were retrieved from hospital records during the 90 days before the event (hazard period) and in four preceding 90-day control periods. Conditional logistic regression was used to obtain β coefficients for change in natural log (ln) transformed C-reactive protein from control to hazard periods and to determine corresponding odds ratios for venous thromboembolism. Median C-reactive protein was 107 mg/L in the hazard period, and ranged from 7 mg/L to 16 mg/L in the control periods. The level of C-reactive protein was 58% (95% CI 39-77%) higher in the hazard period than in the control periods. A one-unit increase in ln-C-reactive protein was associated with increased risk of venous thromboembolism (OR 1.79, 95% CI 1.48-2.16). The risk estimates were only slightly attenuated after adjustment for immobilization and infection. In stratified analyses, ln-C-reactive protein was associated with increased risk of venous thromboembolism in cases with (OR 1.55, 95% CI 1.01-2.38) and without infection (OR 1.77, 95% CI 1.22-2.57). In conclusion, we found that acute inflammation, assessed by C-reactive protein, was a trigger for venous thromboembolism.

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Section: Discussionmentioning

confidence: 79%

“… 7 – 9 However, in studies with shorter follow up time, inflammatory markers such as hs-CRP and neutrophil to lymphocyte ratio were associated with increased risk of VTE. 10 , 11 …”

Section: Introductionmentioning

confidence: 99%

C-reactive protein and risk of venous thromboembolism: results from a population-based case-crossover study

et al. 2018

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“…10 With longer follow-up of the Atherosclerosis Risk in Communities (ARIC) study component of LITE and far more events than in our previous analysis, we reexamined the association of hematocrit with VTE incidence. Because a few research studies have associated VTE risk with other aspects of the complete blood count, 8,[11][12][13][14] and diseases manifest as altered levels of these often increase VTE risk, we also tested in a supplemental analysis whether higher leukocyte or platelet counts in ARIC also may be associated with elevated risk of VTE.…”

Section: Introductionmentioning

confidence: 99%

Hematocrit and incidence of venous thromboembolism

Folsom

Wang

Parikh

et al. 2020

Research and Practice in Thrombosis and Haemostasis

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Background Patients with polycythemia vera with high hematocrit have increased risk of venous thromboembolism (VTE). Objective To determine whether high hematocrit in the general population is also associated with elevated VTE risk. Methods The prospective Atherosclerosis Risk in Communities Study performed a complete blood count in 13 891 adults aged 45 to 64 in 1987 to 1989. We identified incident hospitalized VTEs through 2015 and performed proportional hazards regression analyses using race‐sex–specific categorization of hematocrit percentiles (ie, <5th, 5th to <25th, 25th to <75th, 75th to <95th, and 95th‐100th percentiles, with the 25th to <75th percentile serving as the reference). Results Over a median follow‐up of 26 years, 800 participants had an incident venous thrombosis of the leg and/or a pulmonary embolism. There was a nonlinear association of hematocrit with VTE incidence, with risk elevated 72% for participants above the 95th percentile of hematocrit compared with the reference. Specifically, hazard ratios (95% confidence intervals) of incident VTE were 1.27 (0.91‐1.76), 1.06 (0.87‐1.28), 1 (reference), 1.17 (0.98‐1.40) and 1.72 (1.30‐2.27) across the 5 hematocrit percentiles, adjusted for age, race, sex, body mass index, smoking status and pack‐years, and other confounding variables. The association of high hematocrit with VTE was limited to provoked VTE, with little evidence for unprovoked VTE. Hemoglobin above the 95th percentile also was associated with an increased risk of VTE. In contrast, there were no significant associations of platelet, leukocyte, neutrophil, or lymphocyte counts with VTE incidence. Conclusion High hematocrit and hemoglobin in a general middle‐aged population sample were associated with increased long‐term risk of VTE, particularly provoked VTE.

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“…Similarly, Tokgoz et al and Celikbilek et al also found similar correlation between clinical outcome and NLR in patients hospitalised with stroke [26,27]. Additionally, high NLR has been assessed in venous thrombosis [28]. The investigators of the Tromso study indicated a correlation between elevated NLR and mortality risk among patients with venous thromboembolism [28].…”

Section: Discussionmentioning

confidence: 79%

“…Additionally, high NLR has been assessed in venous thrombosis [28]. The investigators of the Tromso study indicated a correlation between elevated NLR and mortality risk among patients with venous thromboembolism [28].…”

Section: Discussionmentioning

confidence: 99%

Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio are associated with cryptogenic stroke in patients with patent foramen ovale

Çağlar

Erdem

Karabulut

et al. 2020

Arch Med Sci Atheroscler Dis

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Introduction: Although most ischaemic strokes are due to cardioembolism, about 25-40% of strokes are cryptogenic. Patent foramen ovale has been associated with cryptogenic stroke; however, the precise mechanism of this association has not been demonstrated. The aim of this study was to evaluate the association between inflammatory markers and cryptogenic stroke in patients with patent foramen ovale. Material and methods: We included 206 patients with patent foramen ovale. Ninety-four (45.63%) out of 206 patients had had stroke, and 112 (54.37%) had not had stroke. The ratio of the total neutrophil count to the total lymphocyte count was defined as the neutrophil to lymphocyte ratio, and the ratio of the absolute platelet count to the absolute lymphocyte count was determined as the platelet to lymphocyte count. Results: The neutrophil to lymphocyte ratio was significantly higher in patients who had stroke than in those who did not (2.41 ±1.69 vs. 2.19 ±1.74, p = 0.047). Although the platelet to lymphocyte count was also higher in patients who had had stroke than in those who had not, it was not statistically significant (120.94 ±55.45 vs. 118.01 ±52.21, p = 0.729). 1.62 was the cutoff value for neutrophil to lymphocyte ratio to be associated with stroke with 73.4% sensitivity and 45.05% specificity (p = 0.042). Conclusions: This study demonstrated that elevated neutrophil to lymphocyte ratio and platelet to lymphocyte count could be associated with cryptogenic stroke in patients with patent foramen ovale.

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Neutrophil to lymphocyte ratio and future risk of venous thromboembolism and mortality: the Tromso Study

Cited by 21 publications

References 15 publications

C-reactive protein and risk of venous thromboembolism: results from a population-based case-crossover study

C-reactive protein and risk of venous thromboembolism: results from a population-based case-crossover study

Hematocrit and incidence of venous thromboembolism

Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio are associated with cryptogenic stroke in patients with patent foramen ovale

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