Predictive value of neutrophil to lymphocyte ratio in patients with acute ST segment elevation myocardial infarction after percutaneous coronary intervention: a meta-analysis

Abstract

BackgroundThe neutrophil to lymphocyte ratio (NLR) is an indicator of systemic inflammation and a prognostic marker in patients with acute coronary syndrome (ACS). This study aims to investigate the value of NLR to predict the in-hospital and long-term prognosis in patients with ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) by meta-analysis.MethodThe studies related to the prognosis of NLR and STEMI patients published in the Pubmed, Embase, and Ovid databases before June 2017 were retrieved. The relevant data were extracted. Review Manager Version 5.3 was used for meta-analysis.ResultsA total of 14 studies of 10,245 patients with STEMI after PCI were included. A significant difference was observed for mortality (P < 0.001; relative risk (RR) 3.32; 95% confidence interval (CI) 2.45–4.49), hospital cardiac mortality(P < 0.001; RR 3.22; 95% CI 2.25–4.60), all mortality (P < 0.001; RR 3.23; 95% CI 2.28–4.57), major adverse cardiovascular events (MACE) (P < 0.001; RR 2.00; 95% CI 1.62–2.46), in-stent thrombosis (P < 0.001; RR 2.72 95% CI 1.66–4.44), nonfatal myocardial infarction(MI) (P < 0.001; RR 1.93; 95%CI 1.43–2.61), angina (P = 0.007; RR 1.67; 95%CI 1.15–2.41), advanced heart failure (AHF) (P < 0.001; RR 1.81; 95% CI 1.48–2.21), arrhythmia (P = 0.002; RR 1.38; 95% CI 1.13–1.69), no reflow (P < 0.001; RR 2.28; 95% CI 1.46–3.57), long-term all mortality (P < 0.001; RR 3.82; 95% CI 2.94–4.96), cardiac mortality (P = 0.004; RR 3.02; 95% CI 1.41–6.45), MACE (P < 0.001; RR 2.49; 95% CI 1.47–4.23), and nonfatal MI (P = 0.46; RR 1.32; 95% CI 0.63–2.75).ConclusionsMeta-analysis shows that NLR is a predictor of hospitalization and long-term prognosis in patients with STEMI after PCI, but requires further confirmation by large randomized clinical trials.Electronic supplementary materialThe online version of this article (10.1186/s12872-018-0812-6) contains supplementary material, which is available to authorized users.

Variability in blood lipids affects the neutrophil to lymphocyte ratio in patients undergoing elective percutaneous coronary intervention: A retrospective study

“…Increased NLR values may indicate subclinical inflammation [23]. In addition, NLR is associated with pro-inflammatory mediators (high sensitive CRP, tumor necrosis factor-α) and progressive subclinical atherogenesis [24].A high NLR is a predictor of atherosclerosis progression [10,25,26] and long-term prognosis in patients after PCI [12]. As a protective factor for blood vessels, HDL-C has been observed in both healthy people [14] and CAD patients [15] as associated with NLR levels at lower levels.…”

The neutrophil to lymphocyte ratio in heart failure: a comprehensive review

“…Consequently, integrating different yet interdependent immune pathways, the neutrophil to lymphocyte ratio (NLR) was independently correlated to prognosis in various cardiovascular diseases [15], predominantly ischemic heart disease [16], but also arrhythmias [17], valvular disease [18] and heart failure [18].…”

Effect of cardiac rehabilitation on neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in ST elevation myocardial infarction patients

“…In a meta-analysis published in 2018; patients with higher NLR values had more frequent in-hospital angina, advanced cardiac insufficiency, arrhythmia, major cardiovascular events, death due to cardiac causes, all-cause mortality, stent thrombosis, non-fatal myocardial infarction, and no-reflow phenomena. In addition, long-term mortality, cardiac mortality and major cardiovascular events were significantly more frequent; but there was no difference in non-fatal myocardial infarctions [5]. Thus, cardiovascular outcomes correlate with inflammation level.…”