Relationship between Neutrophil-to-Lymphocyte Ratio and Left Ventricular Free Wall Rupture in Acute Myocardial Infarction

Abstract

Objectives: This study aimed to evaluate the relationship between the neutrophil-to-lymphocyte (N/L) ratio and left ventricular free wall rupture (LVFWR) in patients with ST elevation myocardial infarction (STEMI). Previous studies showed a correlation between increased levels of inflammatory markers and adverse cardiovascular events. The role of inflammation markers, particularly the N/L ratio, in mechanical complications after myocardial infarction has not been studied. Methods: Retrospectively, we compared the N/L ratio values of 23 patients with STEMI complicated by LVFWR with 214 STEMI patients without this complication. The diagnosis of rupture was confirmed by echocardiography in each case. Results: Neutrophil counts [median 8.5 × 10³/µl, interquartile range (IQR) 6.4, vs. 7.8 × 10³/µl, IQR 4.7, p = 0.02] and the N/L ratio (5.66, IQR 4.17, vs. 4.1, IQR 3.93, p = 0.01) were significantly higher in the LVFWR group. In receiver operating characteristic analysis, an N/L ratio above 3.7 predicted LVFWR with a sensitivity of 82.6% and a specificity of 46.9% (area under the curve = 0.654, p = 0.016). In multivariate regression analysis, age, hypertension, increased creatinine levels and increased N/L ratio (odds ratio = 1.61, 95% confidence interval = 1.15-2.23, p = 0.01) were found to be independent predictors of LVFWR. Conclusions: In our study, the N/L ratio was found to be independently correlated with the risk of LVFWR.

The Neutrophil-to-Lymphocyte Ratio Is Valuable at All Stages of Coronary Artery Disease

“…In conclusion, Ipek et al [1] reported the N/L ratio as a predictor of rupture of the ventricular wall after MI. In the emergency department, patients with an elevated N/L ratio should be more closely followed up concerning fateful mechanical complications.…”

“…This calculation is very simple and cheap when compared with those involving other inflammatory cytokines. Previous results have demonstrated that adequate collateral circulation has beneficial effects on ventricular function, inIn their article 'Relationship between neutrophil-to-lymphocyte ratio and left ventricular free wall rupture in acute myocardial infarction', Ipek et al [1] showed that the neutrophil-to-lymphocyte (N/L) ratio is an independent predictor of left ventricular free wall rupture (LVFWR) in patients with acute myocardial infarction (MI). N/L ratios >3.7 predicted LVFWR with a sensitivity of 82.6% and a specificity of 46.9%.…”

Single Nucleotide Polymorphisms at +191 and +292 of Galectin-3 Gene (LGALS3) Related to Lower GAL-3 Serum Levels Are Associated with Frequent Respiratory Tract Infection and Vaso-Occlusive Crisis in Children with Sickle Cell Anemia

“…GAL-3 is involved in a variety of biological processes including cellular adhesion, activation, chemotaxis, growth and differentiation, resistance to oxygen and nitrogen radicals damage and apoptosis [16–22]. Moreover, GAL-3 is part of the innate immune response [9,23,24].…”

Znaczenie wskaźnika neutrofilowo-limfocytowego w chorobach układu sercowo-naczyniowego

“…Stwierdzono, że u tych osób wartość NLR przekraczająca 3,7 wiązała się z wyższym ryzykiem powikłania w postaci pęknięcia wolnej ściany mięśnia sercowego (czułość 82,6%, specyficzność 46,9%). Wskaźnik ten, obok wieku, nadciśnienia tętniczego i podwyższonego stężenia kreatyniny, uznano za niezależny czynnik ryzyka pęknięcia wolnej ściany mięśnia sercowego w przebiegu STEMI [15].…”