The Prognostic Significance of Neutrophil to Lymphocyte Ratio (NLR), Monocyte to Lymphocyte Ratio (MLR) and Platelet to Lymphocyte Ratio (PLR) on Long-Term Survival in Off-Pump Coronary Artery Bypass Grafting (OPCAB) Procedures

Abstract

Background: Cardiovascular diseases, apart from commonly known risk factors, are related to inflammation. There are several simple novel markers proposed to present the relation between inflammatory reactions activation and atherosclerotic changes. They are easily available from whole blood count and include neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), and platelets to lymphocyte ratio (PLR). The RDW results were excluded from the analysis. Method and results: The study based on retrospective single-centre analysis of 682 consecutive patients (131 (19%) females and 551 (81%) males) with median age of 66 years (60–71) who underwent off-pump coronary artery bypass grafting (OPCAB) procedure. During the median 5.3 +/− 1.9 years follow-up, there was a 87% cumulative survival rate. The laboratory parameters including preoperative MLR > 0.2 (HR 2.46, 95% CI 1.33–4.55, p = 0.004) and postoperative NLR > 3.5 (HR 1.75, 95% CI 1.09–2.79, p = 0.019) were found significant for long-term mortality prediction in multivariable analysis. Conclusion: Hematological indices NLR and MLR can be regarded as significant predictors of all-cause long-term mortality after OPCAB revascularization. Multivariable analysis revealed preoperative values of MLR > 0.2 and postoperative values of NLR > 3.5 as simple, reliable factors which may be applied into clinical practice for meticulous postoperative monitoring of patients in higher risk of worse prognosis.

Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Impact on Predicting Outcomes in Patients with Acute Limb Ischemia

“…The neutrophil-to-lymphocyte ratio (NLR) is one of the most widely available biomarkers with a significant association with morbidity and mortality in the following study areas: cardiovascular surgery, cardiology, gastric cancer, pancreatic cancer, colorectal cancer, and ovarian cancer [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. Another biomarker of interest is the platelet-to-lymphocyte ratio (PLR), which is intensively studied in the fields of oncology [ 17 , 18 , 19 ], cardiovascular surgery [ 20 ], bipolar disorder [ 21 ], and trauma care [ 22 ]. The proinflammatory role of neutrophils and lymphocytes in immune system modulation has been widely described in the literature [ 23 , 24 ], as well as the role of systemic inflammation in lymphocyte apoptosis [ 25 ], possibly leading to adverse cardiovascular events [ 26 ].…”

Predicting postoperative ischemic stroke problems in patients following coronary bypass surgery using neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and red blood cell distribution width values

“…In a study conducted by Taşoğlu et al in patients with critical leg ischemia, they found that PLR was an independent risk factor for leg amputation [39]; and in another study, they found that preoperative high RDW in patients undergoing coronary bypass surgery was associated with increased long-term mortality [36]. Furthermore, the important conclusion in a study by Urbanowicz et al is the strong relationship between inflammatory markers including monocyte-lymphocyte ratio (MLR), NLR, and PLR in offpump coronary artery bypass grafting (OPCAB) patients and their mortality risk [40].…”

“…Furthermore, the important conclusion in a study by Urbanowicz et al . is the strong relationship between inflammatory markers including monocyte-lymphocyte ratio (MLR), NLR, and PLR in off-pump coronary artery bypass grafting (OPCAB) patients and their mortality risk [ 40 ].…”

Neutrophil Counts, Neutrophil-to-Lymphocyte Ratio, and Systemic Inflammatory Response Index (SIRI) Predict Mortality after Off-Pump Coronary Artery Bypass Surgery

“…Previously, we described the particular features of all mentioned cells and the significance of their indices (NLR, PLR) to immune response in patients with coronary artery disease [ 61 ]. SII is an established prognostic marker of long-term prognosis in coronary revascularization [ 12 ], non-cardiac surgery, or neoplasms [ 62 , 63 ]. Platelets, in turn, are also involved in the inflammatory response by facilitating the recruitment of other inflammatory cells and the release of inflammatory mediators [ 64 ].…”