The pre-procedural neutrophil to lymphocyte ratio (N/L) is associated with adverse outcomes among
patients with coronary artery disease but its prognostic value in ST-segment elevation myocardial infarction
(STEMI) has not been fully investigated. This study evaluated the relations between pre-procedural N/L ratio
and the in-hospital and long-termoutcomes in STEMI patients undergoing primary percutaneous coronary intervention
A total of 682 STEMI patients presentedwithin the first 6 h of symptom onsetwere enrolled and stratified
according to tertiles of N/L ratio based on the blood samples obtained in the emergency room upon admission.
The mean follow-up period was 43.3 months (1–131 months). In-hospital in-stent thrombosis, non-fatal
myocardial infarction, and cardiovascular mortality increased as the N/L tertile ratio increased (p
p=0.003, respectively). Long-term in-stent thrombosis, non-fatalmyocardial infarction and cardiovascular mortality
also increased as the N/L ratio increased (p
b0.001, pb0.001, p=0.002, respectively). On multivariate analysis,
N/L ratio remained an independent predictor for both in-hospital (OR 1.189, 95% CI 1.000
–1.339; pb0.001) and
long-term major (OR 1.228, 95% CI 1.136
–1.328; pb0.001) adverse cardiac events.
The N/L ratio was an independent predictor of both in-hospital and long-term adverse outcomes
among STEMI patients undergoing primary PCI. Our
findings suggest that this inexpensive, universally available
hematological marker may be incorporated into the current established risk assessment model for STEMI.