Neutrophil to Lymphocyte Ratio in Acute ST-Segment Elevation Myocardial Infarction

Erkol, Ayhan; Turan, Burak; Oduncu, Vecih; Kılıçgedik, Alev; Karabay, Can Yücel; Akgün, Taylan; Güler, Ahmet; Pala, Selçuk; Kırma, Cevat

doi:10.1097/maj.0000000000000188

Cited by 30 publications

(24 citation statements)

References 36 publications

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“…Abnormally elevated NLR on admission were proved to be correlated with long-term prognosis in STEMI patients who underwent pPCI. 17 Results from several previous studies confirmed favorable value of preprocedure NLR in predicting adverse outcomes including pump failure, cardiogenic shock, severe ventricular arrythmias, 18 stent thrombosis, 19 angiographic thrombus burden 20 and long-term mortality 21 among STEMI patients, no matter whether pPCI was performed, and even independent of GRACE risk score in patients with STEMI. 22 Furthermore, Horne et al 23 emphasized the predominant predictive value of NLR in predicting death/MI among a serious of hematological indices containing of neutrophil, lymphocyte and NLR.…”

Section: Discussionmentioning

confidence: 72%

Anemia and Inflammation in ST-Segment Elevation Myocardial Infarction

Zhang

Che

Chen

et al. 2015

The American Journal of the Medical Sciences

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Abstract:Background:To investigate the factors predicting the onset of major adverse cardiovascular events (MACEs) after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI) patients.Methods:Two hundred forty-eight STEMI patients (61.4 ± 10.8 years, 186 men) who underwent successful primary percutaneous coronary intervention were enrolled. Patients were followed-up for 1 year. Univariate, multivariate analyses, and receiver operating characteristic curve analysis were performed to determine the factors predicting MACEs.Results:There were 36 patients (14.5%) who experienced MACEs in the follow-up period. Multivariate logistic regression analysis demonstrated that hemoglobin (HgB) (odds ratio = 0.972; 95% CI, 0.948–0.998; P = 0.033), neutrophil/lymphocyte ratio (NLR) (odds ratio = 1.511; 95% CI, 1.148–1.987; P = 0.003), Global Registry of Acute Coronary Event score, and postprocedure left ventricular ejection fraction (LVEF) were independent predictors of MACEs. Further subgroup analysis showed higher NLR (>8.61), Global Registry of Acute Coronary Event score (>167) and lower HgB (<131 g/L) all show superior predictive value for patients with relatively higher LVEF (>48%); moreover, the c-statistic of NLR and HgB both exceed 0.7. However, among patients with lower LVEF (≤48%), higher NLR and lower HgB lost the ability for predicting 1 year MACEs independently. In addition, abnormally higher NLR (>8) could predict 1-month MACEs efficiently.Conclusions:In summary, among STEMI patients, elevated NLR, decreased HgB level on admission both predicted 1-year MACEs independently, especially for those with relatively preserved LVEF (>48%). Besides, abnormally higher NLR on admission should attract their attention for short-term MACEs.

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Section: Discussionmentioning

confidence: 72%

Anemia and Inflammation in ST-Segment Elevation Myocardial Infarction

Zhang

Che

Chen

et al. 2015

The American Journal of the Medical Sciences

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“…NLR has been considered as a marker of subclinical inflammation. In CAD, it has been reported that NLR is an independent predictor of cardiovascular events and mortality in ST‐segment elevation MI 28 . NLR could also be a predictor of critical stenosis and associated with both the severity and plaque morphology of coronary atherosclerotic disease 29 .…”

Section: Discussionmentioning

confidence: 98%

Systemic immune‐inflammation index (SII) predicted clinical outcome in patients with coronary artery disease

Yang

Wu²,

Hsu³

et al. 2020

Eur J Clin Investigation

371

300

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Background: This study examines the predictive value of a novel systemic immuneinflammation index (SII, platelet × neutrophil/lymphocyte ratio) in coronary artery disease (CAD) patients. Methods: A total of 5602 CAD patients who had undergone a percutaneous coronary intervention (PCI) were enrolled. They were divided into two groups by baseline SII score (high SII vs low SII) to analyse the relationship between SII groups and the long-term outcome. The primary outcomes were major cardiovascular events (MACE) which includes nonfatal myocardial infarction (MI), nonfatal stroke and cardiac death. Secondary outcomes included a composite of MACE and hospitalization for congestive heart failure. Results: An optimal SII cut-off point of 694.3 × 10 9 was identified for MACE in the CAD training cohort (n = 373) and then verified in the second larger CAD cohort (n = 5602). Univariate and multivariate analyses showed that a higher SII score (≥694.3) was independently associated with increased risk of developing cardiac death (HR: 2.02; 95% CI: 1.43-2.86), nonfatal MI (HR: 1.42; 95% CI: 1.09-1.85), nonfatal stroke (HR: 1.96; 95% CI: 1.28-2.99), MACE (HR: 1.65; 95% CI: 1.36-2.01) and total major events (HR: 1.53; 95% CI: 1.32-1.77). In addition, the SII significantly improved risk stratification of MI, cardiac death, heart failure, MACE and total major events than conventional risk factors in CAD patients by the significant increase in the C-index (P < .001) and reclassification risk categories by significant NRI (P < .05) and IDI (P < .05). Conclusions: SII had a better prediction of major cardiovascular events than traditional risk factors in CAD patients after coronary intervention. K E Y W O R D Scoronary artery disease, inflammation, percutaneous coronary intervention 2 of 11 | YANG et Al.

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“…Previous studies have shown that ST-segment resolution $70% in STEMI patients receiving thrombolytic therapy indicated not only the patency of the IRA but also the microvascular and myocardial reperfusion (5). More recently, N/L ratio, a novel inflammatory marker, has been demonstrated to be associated with the patency of the IRA in STEMI patients before mechanical reperfusion therapy (6,7). In these studies, the results showed that STEMI patients with patent IRA had lower N/L ratio than patients with occluded IRA and the N/L ratio was an independent predictor of the patency of the IRA.…”

Section: Discussionmentioning

confidence: 96%