Utility of the neutrophil to lymphocyte ratio for predicting in-hospital mortality after levosimendan infusion in patients with acute decompensated heart failure

Taşal, Abdurrahman; Ertürk, Mehmet; Uyarel, Hüseyin; Karakurt, Huseyin; Bacaksız, Ahmet; Vatankulu, Mehmet Akıf; Turfan, Murat; Sönmez, Osman; Erdoğan, Ercan; Ergelen, Mehmet

doi:10.1016/j.jjcc.2013.10.009

Cited by 23 publications

(24 citation statements)

References 36 publications

(39 reference statements)

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“…28) A higher N/L ratio has also been shown to be associated with an increased risk of in-hospital mortality in patients with acute heart failure. 15,29) In this study, the highest tertile of the N/L ratio was associated with an increased risk of MCE in elderly patients with CHF. We also found similar associations between the N/L ratio and cardiac death and rehospitalization for heart failure after multivariate adjustments.…”

Section: Discussionmentioning

confidence: 47%

“…[8][9][10] The N/R ratio has been shown to be independently associated with the severity of coronary artery disease in patients with non-ST segment elevation myocardial infarction, and the ability of the N/L ratio to predict cardiovascular risk in various patient groups has been analyzed in several studies, including in patients with CKD. 7,[11][12][13][14][15][16] However, to date, the N/L ratio has not been investigated in elderly patients with CHF. In our study, we evaluated the association between the N/L ratio and the future risk of major cardiovascular events (MCE) in elderly patients admitted with CHF.…”

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confidence: 99%

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Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting Adverse Events in Elderly Patients With Chronic Heart Failure

Yan

et al. 2016

Int. Heart J.

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SummaryThe neutrophil-to-lymphocyte (N/L) ratio has been associated with poor outcomes in patients with cardiovascular diseases, but it has not been studied in elderly patients with chronic heart failure (CHF).In this study, we analyzed 1355 elderly patients admitted with CHF. A multivariate logistic regression model was used to assess the independent association of the N/L ratio with chronic kidney disease (CKD). The patients were then divided into tertiles according to the N/L ratios. We used Cox regression analysis to assess the association between the N/L ratio and subsequent major cardiovascular events (MCE), including cardiac death and rehospitalization for heart failure.In the multiple logistic regression analysis, the N/L ratio was identified as a risk factor for CKD in elderly patients with CHF (odds ratio [OR] = 1.170, 95% confidence interval [CI] 1.054 to 1.298, P = 0.003). The median follow-up period was 18 months. In a multivariate analysis with the lowest tertile as the reference, the highest tertile of the N/L ratio remained significantly associated with MCE (hazard ratio [HR] = 1.425, 95% CI 1.109 to 1.832, P = 0.006), cardiac death (HR = 1.747, 95% CI 1.032 to 2.958, P = 0.038), and rehospitalization for heart failure (HR = 1.461, 95% CI 1.108 to 1.927, P = 0.007).In elderly patients with CHF, the N/L ratio is one of the important risk factors for CKD and the highest tertile of the N/L ratio is associated with an increased risk for MCE. (Int Heart J 2016; 57: 615-621)

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Section: Discussionmentioning

confidence: 47%

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confidence: 99%

Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting Adverse Events in Elderly Patients With Chronic Heart Failure

Yan

et al. 2016

Int. Heart J.

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“…Furthermore, the NLR functions as a prognostic marker of adverse outcomes in patients undergoing cardiac revascularization [24,25], as well as long-term mortality in those with acute coronary syndrome (ACS) [26][27][28], and is also an independent predictor of cardiac mortality in subjects with stable CAD [29]. In addition to stable and acute CAD, the NLR values reflect the severity of dilated cardiomyopathy [30] and are predictive of mortality in patients with HF [31][32][33] as well as peripheral arterial disease [34].…”

Section: Nlr and Osamentioning

confidence: 99%

The relationship between neutrophil to lymphocyte ratio, endothelial function, and severity in patients with obstructive sleep apnea

Oyama

Nagashima

Yoshioka

et al. 2016

Journal of Cardiology

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“…Several studies over the past few decades have demonstrated the potential of beutrophil-to-lymphocyte Ratio (NLR), a widely available hematologic marker of oxidative stress damage, to serve as a good prognostic marker of mortality in cardiac and non-cardiac diseases 3-7 . In this study, we evaluated the association between NLR and future risk of mortality or cardiac transplantation in a large contemporary cohort of patients with advanced HF.…”

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confidence: 99%

Usefulness of Neutrophil-to-Lymphocyte Ratio in Risk Stratification of Patients With Advanced Heart Failure

Benítes-Zapata

Hernandez

Nagarajan

et al. 2015

The American Journal of Cardiology

115

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Elevated neutrophil-to-lymphocyte Ratio (NLR) has been associated with increased mortality in patients with acute heart failure (HF) as well as in neoplastic diseases. We investigated the association between NLR and mortality or cardiac transplantation in a retrospective cohort of 527 patients presented to the Cleveland Clinic for evaluation of advanced HF therapy options between 2007 and 2010. Patients were divided according to low, intermediate, and high tertiles of NLR, and were followed longitudinally for time to all-causes mortality or heart transplantation (primary outcome). The median NLR was 3.9 (IQR 2.5, 6.5). In univariate analysis, intermediate and highest tertiles of NLR had a higher risk than the lowest tertile for the primary outcome and all-causes mortality. Compared to the lowest tertile, there was no difference in the risk of heart transplantation for intermediate and high tertiles. In multivariate analysis, when compared to the lowest tertile, the intermediate and high NLR tertiles remained significantly associated with the primary outcome (HR=1.61 [95%CI 1.10 to 2.37] and HR=1.55 [95%CI 1.02 to 2.36], respectively), and all-causes mortality (HR=1.83 [95%CI 1.07 to 3.14] and HR=2.16 [95%CI 1.21 to 3.83], respectively). In conclusion, elevated NLR is associated with increased mortality or heart transplantation risk in patients with advanced HF.

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Utility of the neutrophil to lymphocyte ratio for predicting in-hospital mortality after levosimendan infusion in patients with acute decompensated heart failure

Abstract: Levosimendan treatment was associated with significant changes in hematological variables in patients with ADHF. A sustained higher N/L ratio after levosimendan infusion is associated with an increased risk of in-hospital mortality in patients with ADHF.

Cited by 23 publications

References 36 publications

Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting Adverse Events in Elderly Patients With Chronic Heart Failure

Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting Adverse Events in Elderly Patients With Chronic Heart Failure

The relationship between neutrophil to lymphocyte ratio, endothelial function, and severity in patients with obstructive sleep apnea

Usefulness of Neutrophil-to-Lymphocyte Ratio in Risk Stratification of Patients With Advanced Heart Failure

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