Value of Early Risk Stratification Using Hemoglobin Level and Neutrophil-to-Lymphocyte Ratio in Patients With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Cho, Kyung Hoon; Jeong, Myung Ho; Ahmed, Khurshid; Hachinohe, Daisuke; Choi, Hong Sang; Chang, Soo Y.; Kim, Min Chul; Hwang, Seung Hwan; Park, Keun Ho; Lee, Min Goo; Ko, Jum Suk; Sim, Doo Sun; Yoon, Nam Sik; Yoon, Hyun Ju; Hong, Young Joon; Kim, Kye Hun; Kim, Ju Han; Ahn, Youngkeun; Cho, Jeong Gwan; Park, Jong Chun; Kang, Jung Chaee

doi:10.1016/j.amjcard.2010.10.067

Cited by 93 publications

(91 citation statements)

References 26 publications

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“…In a study that included 300 patients who were admitted to hospital with ACS, higher NLR (median: 6.03 [4.48-7.9]) was associated with higher 30-day in-hospital mortality [17]. Another study reported by Cho et al [18] showed that use of combination of NLR and haemoglobin provided valuable information for early risk stratification in patients with ST Data are expressed as mean ± standard deviation; AST -aspartate amino transferase; ALT -alanine amino transferase Table 3. Correlation of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with severity of coronary artery disease SYNTAX score GENSINI score r p r p…”

Section: Discussionmentioning

confidence: 90%

Relation of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio with coronary artery disease severity in patients undergoing coronary angiography

et al. 2015

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A b s t r a c tBackground: Atherosclerosis is a chronic systemic inflammatory disease. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are systemic inflammatory markers that are correlated with poor cardiovascular outcomes. Aim:To explore the relation of NLR and PLR with severity of coronary artery disease (CAD). Methods:The study population consisted of 180 consecutive patients who underwent elective coronary angiography (CAG). While 100 patients (22 female, mean age: 60.6 ± 12.6 years) had abnormal CAG, 80 patients (44 female, mean age: 57.2 ± 10.9 years) had normal CAG. NLR and PLR were calculated as the ratio of neutrophil count to lymphocyte count and as the ratio of platelet count to lymphocyte count, respectively. Results:Although age distribution was similar between the two groups (p = 0.073), female gender was significantly higher in the normal CAG group (p < 0.001). Patients with abnormal CAG had significantly higher NLR and PLR when compared to patients with normal CAG (3.7 ± 2.6 vs. 2.2 ± 1.7, p < 0.001 and 125.9 ± 72.3 vs. 102.6 ± 33.8, p = 0.027, respectively). NLR and PLR were significantly correlated with SYNTAX score and GENSINI score. In logistic regression analyses, only NLR (odds ratio: 1.576, confidence interval: 1.198-2.072, p = 0.001) was an independent predictor of CAD. An NLR of 2.3 or higher predicted the CAD with a sensitivity of 66% and specificity of 70%.Conclusions: NLR and PLR seem to be a simple method to predict severity of CAD in patients undergoing elective CAG, and it may be part of cardiovascular examination before CAG.

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Section: Discussionmentioning

confidence: 90%

Relation of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio with coronary artery disease severity in patients undergoing coronary angiography

et al. 2015

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“…Benzer şekilde koroner arter hastalıklarında, periferik damar hastalıklarında, inmede ve derin ven trombozunda nötrofil sayısındaki artışın trombüs oluşumunda artışla ve iskemik hasarın daha yaygın olmasıyla ilişkili olduğu gösterilmiştir (12)(13)(14)(15). Kardiovasküler hastalıklarda lökositler ve trombositler arasındaki etkileşimin, özellikle trombositlerle nötrofillerin bir arada kümeleşmesinin daha aktive trombositlerin oluşmasına neden olduğu belirtilmektedir.…”

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The prognostic value of increased leukocyte and neutrophil counts in the early phase of cerebral venous sinus thrombosis

Kamışlı¹,

Kamışlı²,

Gönüllü³

et al. 2012

Türk Beyin Damar Hast Derg

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“…Interestingly, the ratio of the absolute number of neutrophils to that of lymphocytes (neutrophil-to-lymphocyte ratio: NLR), a particular WBC parameter, has newly emerged as an inflammatory marker for identifying individuals at risk of CAD [8][9][10][11][12][13] . However, only recently have studies of the relationship between the NLR and the severity of CAD begun to be conducted.…”

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confidence: 99%

Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting the Severity of Coronary Artery Disease: A Gensini Score Assessment

Chen

et al. 2014

JAT

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Aim:The usefulness of the white blood cell (WBC) count and neutrophil-to-lymphocyte ratio (NLR) in predicting the severity of stable coronary artery disease (CAD) has not been sufficiently evaluated, particularly based on strict coronary assessments. The aim of the present study was to investigate the WBC count and NLR in predicting the severity of angiographically proven CAD. Methods: A total of 2,976 CAD patients and 571 non-CAD patients were consecutively enrolled, and the CAD patients were classified into the three groups according to the tertile of the Gensini score (GS, low GS＜18, n = 989; intermediate GS 18-41, n = 995 and high GS＞41, n = 992). The efficacy of the WBC count and NLR in predicting the risk and severity of CAD as well as the correlations between these markers and the GS were analyzed. A receiver operating characteristic (ROC) curve analysis was also performed. Results: The NLR was found to be an independent predictor of both the presence of CAD (OR = 1.18, 95%CI: 1.09-1.27, p = 0.009) and a high GS (OR=1.10, 95%CI: 1.01-1.16, p = 0.032). In addition, there were mild positive correlations between the GS and the NLR, WBC and proportions of neutrophils and monocytes. In the ROC curves analysis, the NLR was found to have the largest area under the curve (AUC = 0.63, 95%CI: 0.59-0.67, p=0.000), with an optimal cut-off value of 2.04 (sensitivity: 62.1%, specificity: 54.8%) for predicting a high GS. Conclusions: The NLR is a valuable independent predictor of the severity of CAD assessed according to the GS. In particular, an NLR of ＞2.04 indicates a higher risk of CAD and greater severity of CAD lesions. Hypertension was diagnosed based on repeated blood pressure measurements of ≥ 140/90 mmHg (at least two times in different environments) or the use of antihypertensive drugs. DM was diagnosed based on a fasting serum glucose level of ≥ 6.99 mmol/L on multiple occasions and/or the use of insulin or oral hypoglycemic agents. Dyslipidemia was diagnosed according to a fasting total cholesterol level of (TC) ≥ 200 mg/dL or triglyceride (TG) level of ≥150 mg/dL. J Atheroscler Laboratory TestsAll baseline laboratory data were acquired from venous blood samples obtained after a 12-hour overnight fast prior to coronary angiography. The levels of WBC, neutrophils, lymphocytes and monocytes were determined using an automated blood cell counter, the Coulter LH780 Hematology Analyzer (Beckman Coulter Ireland Inc. Mervue, Galway, Ireland), and the levels of high-sensitivity C-reactive protein (hs-CRP) were assessed using immunoturbidimetry (Beckmann Assay 360, Bera, California, USA), as previously reported 16,17) . The NLR was calculated as the ratio of neutrophils to lymphocytes, the levels of which were obtained from the same blood samples. The normal range of hs-CRP in our hospital laboratory is 0-3 mg/L. Angiographic ExaminationsSelective coronary angiography was performed in all enrolled subjects using the standard Judkin's technique, and the results were analyzed by at least two interventional physicians w...

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Value of Early Risk Stratification Using Hemoglobin Level and Neutrophil-to-Lymphocyte Ratio in Patients With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Cited by 93 publications

References 26 publications

Relation of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio with coronary artery disease severity in patients undergoing coronary angiography

Relation of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio with coronary artery disease severity in patients undergoing coronary angiography

The prognostic value of increased leukocyte and neutrophil counts in the early phase of cerebral venous sinus thrombosis

Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting the Severity of Coronary Artery Disease: A Gensini Score Assessment

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