Relationship Between Prodromal Angina Pectoris and Neutrophil-to Lymphocyte Ratio in Patients With ST Elevation Myocardial Infarction

Gök, Murat; Kundi, Harun; Kızıltunç, Emrullah; Evlice, Mert; Çetın, Mustafa; Süleymanoğlu, Muhammed; Kurtul, Alparslan; Örnek, Ender

doi:10.1016/j.hlc.2018.04.283

Cited by 6 publications

(5 citation statements)

References 27 publications

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“…Moreover, patients in the high MPVLR and high GRACE score group showed significantly lower rates of prodromal angina compared with the other three groups. These results are consistent with previous results from Gok et al (35). However, the relationship between PA absence and increases in MPVLR and GRACE scores is not fully understood.…”

Section: Discussionsupporting

confidence: 92%

“…GRACE, global registry of acute coronary events; MPVLR, mean platelet volume to lymphocyte ratio; MACE, major adverse cardiovascular events; AUC, area under the curve. microcirculation after reperfusion (35,37). Therefore, the absence of PA in patients with STEMI often indicates that the disease is more serious, and the corresponding GRACE score is higher and with poorer prognosis (38).…”

Section: Discussionmentioning

confidence: 99%

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Prognostic value of the combination of GRACE risk score and mean platelet volume to lymphocyte count ratio in patients with ST‑segment elevation myocardial infarction after percutaneous coronary intervention

et al. 2020

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The Global Registry of Acute Coronary Events (GRACE) risk score and the mean platelet volume to lymphocyte count ratio (MPVLR) can be used independently to predict adverse outcomes in patients with acute coronary syndromes. However, the level of MPVLR in relation to the GRACE score, and whether a combination of these methods can better predict the clinical adverse outcome of patients with ST-segment elevation myocardial infarction (STEMI), have not been previously examined. Therefore, the aim of the present study was to investigate whether the combination of GRACE risk score and MPVLR is a good predictor of a 30-day major adverse cardiovascular events (MACE) in patients with STEMI. A total of 464 patients with STEMI undergoing percutaneous coronary intervention (PCI) were enrolled, and divided into four groups based on the optimal cutoff values for GRACE score and MPVLR. GRACE score and MPVLR levels were separately recorded during admission. Spearman's rank correlation analysis showed a positive correlation between GRACE score and MPVLR (ρ=0.304; P<0.001). Both GRACE score [hazard ratio (HR), 1.706; 95% CI, 1.435-3.058; P<0.001] and MPVLR level (HR, 1.668; 95% CI, 1.202-2.170; P<0.001) were found to be independent predictors of a 30-day MACE. Additionally, the high MPVLR + high GRACE score group of patients had an HR of 2.455 (95% CI, 1.736-3.188) for a 30-day MACE, when using the low MPVLR + low GRACE score group as a reference. Based on the area under the curve, MPVLR combined with GRACE scores achieved an improved performance in differentiating angiographic no-reflow during a 30-day MACE, compared with individual MPVLR and GRACE scores. Therefore, the present results suggested that the GRACE score may be positively correlated with MPVLR and that their combination accurately predicted the occurrence of short-term MACE in patients with STEMI after PCI.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Prognostic value of the combination of GRACE risk score and mean platelet volume to lymphocyte count ratio in patients with ST‑segment elevation myocardial infarction after percutaneous coronary intervention

et al. 2020

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“…These data indicate that the NLR is related to the severity and morphology of coronary atherosclerosis. Moreover, the NLR is reportedly a strong independent predictor of long-term clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) [28,29]. An earlier study compared the predictive power of NLR and MPV for adverse events after the first percutaneous coronary intervention in patients with acute STEMI.…”

Section: Discussionmentioning

confidence: 99%

Blood immune inflammatory indicators predict prognosis in patients with coronary artery disease

et al. 2023

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Background The relationship between the combined hematological parameters and echocardiography and long‐term prognosis in patients with coronary artery disease (CAD) remains unclear. Methods We examined the ability of hematological parameters to predict all‐cause death and major adverse cardiovascular events (MACE) based on Lasso Cox regression analysis. The significant predictors of hematological parameters from the Lasso Cox model were analyzed via multivariate Cox regression analysis and by adjusting for echocardiographic data. We calculated the continuous net reclassification improvement (cNRI) and integrated discrimination improvement (IDI) of the hematological parameters to assess the improvement in prediction. Results A low hemoglobin and lymphocyte ratio and high hematocrit, red blood cell distribution width‐coefficient of variation, and monocyte ratio significantly increased the risk of MACE and death in CAD patients. Neutrophil‐to‐lymphocyte ratio was associated with MACE but not death in CAD patients. After adjustment for echocardiographic parameters, hemoglobin, hematocrit, and lymphocyte ratio remained independently related to death and MACE. The addition of hematological and echocardiographic parameters to the Framingham risk score model significantly improved the area under the curve of mortality (0.794 vs. 0.713, p = 0.0007) and reclassification with cNRI of 30.6% (p = 0.002) and IDI of 0.055 (p < 0.001). Mendelian randomization analyses identified that fibrinogen and neutrophil‐to‐lymphocyte ratio were associated with increased brain natriuretic peptide and decreased left ventricular ejection fraction. Conclusions These findings suggest that the blood immune inflammatory indicators fibrinogen and neutrophil‐to‐lymphocyte ratio were causally associated with the risk of heart failure after CAD. The combination of hematological biomarkers and echocardiography parameters as predictor variables is a useful predictive tool for all‐cause mortality in patients with CAD.

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“…PIA is typical angina pectoris occurring within 24 hours before the onset of AMI patients [12]. Reiter et al showed that AMI patients with PIA have smaller infarct area and higher ejection fraction compared to AMI patients without PIA, the mechanism of which may be related to PIA activated ischemic preconditioning (IP) [13].…”

Section: Clinical Researchmentioning

confidence: 99%

“…In contrast, nontypical angina (NTA) may be defined as symptoms ascribed as angina that do not meet criteria for TA. Pre-infarction angina (PIA) refers to the onset of typical angina pectoris within 24 hours prior to the onset of AMI symptoms and lasting less than 30 minutes [12]. Studies have shown that PIA is associated with ischemic preconditioning of occluded coronary arteries, and this has a protective effect on myocardial infarction and can also reduce its size [13,14].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Pre-Infarction Angina Combined with Mean Platelet Volume to Lymphocyte Count Ratio for No-Reflow and Short-Term Mortality in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Chen

Meng²,

Shao

et al. 2020

Med Sci Monit

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The aim of the present study was to investigate the clinical predictive value of pre-infarction angina (PIA) combined with mean platelet volume to lymphocyte count ratio (MPVLR) for no-reflow phenomenon and shortterm mortality in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). Material/Methods: A total of 1009 STEMI patients who had undergone PCI were enrolled and subdivided into 4 groups based on the occurrence of PIA and the presence of MPVLR above or below the cutoff value. Analysis of the predictors of the no-reflow phenomenon and 90-day mortality was conducted. Further, evaluation and comparison of the clinical predictive value of PIA, MPVLR, and their combination were done. Results: Both MPVLR (odds ratio [OR]=1.476, 95% confidence interval [CI]: 1.401 to 1.756, P<0.001; hazard ratio [HR]=1.430, 95% CI: 1.287 to 1.643, P<0.001) and PIA (OR=0.905, 95% CI: 0.783 to 0.986, P<0.001; HR=0.878, 95% CI: 0.796 to 0.948, P<0.001) were independent predictors of no-reflow phenomenon and 90-day mortality. Spearman's rank correlation test revealed that MPVLR (r=-0.297, P<0.001), monocyte to lymphocyte count ratio (MLR) (r=-0.211, P<0.001) and neutrophil to lymphocyte count ratio (NLR) (r=-0.389, P<0.001) in peripheral blood were significantly negatively correlated with postoperative left ventricular ejection fraction (LVEF). Upon comparing the area under curve (AUC), the MPVLR combined with PIA achieved better performance in differentiating no-reflow phenomenon (AUC=0.847, 95% CI: 0.821 to 0.874) and 90-day mortality (AUC=0.790, 95% CI: 0.725 to 0.855), than the GRACE score, MPVLR and PIA alone, and had similar performance to all other pairwise combinations of the GRACE score, MPVLR and PIA. Conclusions: High MPVLR and PIA were independent predictors of the no-reflow phenomenon and 90-day mortality in patients with STEMI after PCI. Moreover, Combined application of MPVLR and PIA can effectively predict the occurrence of the no-reflow phenomenon and 90-day mortality.

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Relationship Between Prodromal Angina Pectoris and Neutrophil-to Lymphocyte Ratio in Patients With ST Elevation Myocardial Infarction

Cited by 6 publications

References 27 publications

Prognostic value of the combination of GRACE risk score and mean platelet volume to lymphocyte count ratio in patients with ST‑segment elevation myocardial infarction after percutaneous coronary intervention

Prognostic value of the combination of GRACE risk score and mean platelet volume to lymphocyte count ratio in patients with ST‑segment elevation myocardial infarction after percutaneous coronary intervention

Blood immune inflammatory indicators predict prognosis in patients with coronary artery disease

Prognostic Value of Pre-Infarction Angina Combined with Mean Platelet Volume to Lymphocyte Count Ratio for No-Reflow and Short-Term Mortality in Patients with ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

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