Predictive Value of Neutrophil to Lymphocyte Ratio in Clinical Outcomes of Non-ST Elevation Myocardial Infarction and Unstable Angina Pectoris

Abstract

We sought to determine the prognostic value of neutrophil to lymphocyte ratio (NLR) in non-ST elevation myocardial infarction (NSTEMI) and unstable angina pectoris (UAP). A total of 308 (mean age 59.22 ± 11.93) patients with NSTEMI and UAP were prospectively evaluated. The study population was divided into tertiles based on admission NLR values. The patients were followed for clinical outcomes for up to 3 years after discharge. In the Kaplan-Meier survival analysis, 3-year mortality was 21.6% in patients with high NLR versus 3% in the low-NLR group (P < .001). In a receiver-operating characteristic curve analysis, an NLR value of 3.04 was identified as an effective cut point in NSTEMI and UAP of a 3-year cardiovascular mortality (area under curve [AUC] = 0.86, 95% confidence interval [CI] 0.8-0.92). An NLR value >3.04 yielded a sensitivity of 79% and specificity of 71%. Admission NLR is the strong and independent predictor of a 3-year cardiovascular mortality in patients with NSTEMI and UAP.

Neutrophil‐to‐lymphocyte ratio and platelet‐to‐lymphocyte ratio as predictors of survival after heart transplantation

“…NLR AUC in our study in HTX showed better performance for in‐hospital mortality compared with the AUC for predicting major adverse cardiovascular events after percutaneous coronary interventions,26 or saphenous vein graft disease,27 and atrial fibrillation20 after CABG. On the contrary, other studies have showed better NLR AUC for mortality both in HF28, 29 and in non‐ST elevation myocardial infarction 30. The results for PLR were different, and most studies have showed a better predictive value in ST elevation myocardial infarction,13, 14, 15 HF,28, 29 and transcatheter aortic valve replacement,21 and after percutaneous coronary interventions26 or after implantable cardioverter defibrillator placement 18.…”

Neutrophil-to-lymphocyte ratio as an independent predictor of left main and/or three-vessel disease in patients with non-ST-segment elevation myocardial infarction

“…A relative lymphocytopenia has been reported to be an early marker of myocardial infarction [25] and is associated with increased long-term mortality in patients with CAD [26]. NLR is a combination of these two biomarkers involved in the inflammatory process of atherosclerosis, and has been shown to predict adverse cardiovascular events in STEMI [27,28], non-ST-segment elevation acute coronary syndrome [29][30][31], and stable CAD [32,33].…”

Racial differences in the neutrophil-to-lymphocyte ratio in patients with non-ST-segment elevation myocardial infarction

“…The neutrophil-to-lymphocyte ratio (NLR) predicts short-term and long-term adverse outcomes in various clinical settings, including ST-segment elevation myocardial infarction [1][2][3][4], non-ST-segment elevation acute coronary syndrome [2,5,6], and stable coronary artery disease (CAD) [7,8]. Recently, NLR has been reported to independently predict cardiovascular mortality in an asymptomatic general population [9].…”