Neutrophil to lymphocyte ratio as a predictor of myocardial damage and cardiac dysfunction in acute coronary syndrome patients

Abstract

BackgroundNeutrophil to lymphocyte ratio (NLR) in peripheral blood is established to correlate with the morbidity and mortality of heart disease patients. We aimed to define the severity of inflammation (NLR) by observing the association of NLR with cardiac functions or myocardial damage parameters in patients with acute myocardial infarction.MethodsData from 715 patients who underwent percutaneous coronary intervention (PCI) within 72 hours of incidence in 2016 were analysed retrospectively.ResultsThe NLR ranges from 0.50 to 46 (medium ± SD, 2.76 ± 2.96) in 715 patients. NLR positively correlated with myocardial damage (NLR vs. CK-mB: p < 0.0001) but negatively correlated with myocardial function (NLR vs. EF: p < 0.0001; NLR vs. FS: p < 0.0001). Myocardial damage markers (CK, CK-mB, ASL, LDH) were significantly increased, and cardiac contractile parameters (EF and FS) were reduced at NLR > 2.76 compared to those of NLR < 2.76. ELISA analysis has shown that IL-10 was significantly increased when NLR ≥ 4.6 and TGF-β was increased at NLR > 4. The correlation was diminished between NLR and CK-mB at NLR > 2.76 or at NLR > 4, but that of NLR and EF or FS was maintained in NLR > 2.76 and at NLR > 4. EF and FS were comparable between NLR > 2.76 and NLR > 4. But myocardial damage parameters increased significantly at NLR > 4 compared to those of NLR > 2.76.ConclusionNLR is a strong predictor of myocardial damage in acute myocardial patients. High NLR are associated with myocardial dysfunction in all the patients. Severe inflammation (NLR) can predict the consequence of the heart in patients with coronary syndrome.

Correlation between neutrophil‐to‐lymphocyte ratio and kidney dysfunction in undiagnosed hypertensive population from general health checkup

“…Similar increment in NLR was observed in disease conditions . Previously, we have shown that mean NLR in 715 acute myocardial infarction patients on admission without failure or infection was 2.76; mean NLR was 2.65 when GRACE risk score was 100 and NLR was >6.5 when GRACE risk score was over 140 . Arbel et al explored that NLR (>6.5) was associated with lower EF and increased 30 days and 5‐year mortality .…”

Role of circulatory leukocyte based indices in short-term mortality of patients with heart failure with reduced ejection fraction

“…The NLR as an indicator of systemic inflammation is associated with poor clinical outcomes in cardiovascular diseases such as acute coronary syndrome [ 15 ]. Recent evidence showed that high NLR was associated with an increased risk of mortality and complications in post-acute myocardial infarction [ 16 , 17 ]. Turcato et al [ 18 ] showed that the values of NLR and PLR were higher in acute decompensated heart failure patients who died within 30 days…”

Neutrophil‐to‐lymphocyte ratio can specifically predict the severity of hypertriglyceridemia‐induced acute pancreatitis compared with white blood cell

“…During recent years, neutrophil‐to‐lymphocyte ratio (NLR) has been proved of great value with a significant correlation with systemic inflammation reaction in several autoimmune diseases . Because NLR can be easily obtained at low cost through an automatic hematology analyzer, many research groups have further confirmed the value of NLR in predicting disease severity and worse clinical outcomes in a variety of diseases, including cerebrovascular diseases, cardiovascular diseases, and neoplasm . Besides, cumulative evidence has suggested that NLR was associated with AP and better than other serum markers in predicting severity and prognosis of AP.…”