Prognostic value of neutrophil/lymphocyte ratio in patients with ST-elevated myocardial infarction undergoing primary coronary intervention: A prospective, multicenter study

KAYA M. G., AKPEK M., LAM Y. Y., Yarlioglues M., ÇELİK T., GÜNEBAKMAZ O., ...More

INTERNATIONAL JOURNAL OF CARDIOLOGY, vol.168, no.2, pp.1154-1159, 2013 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 168 Issue: 2
  • Publication Date: 2013
  • Doi Number: 10.1016/j.ijcard.2012.11.074
  • Journal Name: INTERNATIONAL JOURNAL OF CARDIOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.1154-1159
  • Keywords: Neutrophil/lymphocyte ratio, ST-segment elevation myocardial infarction, Primary percutaneous coronary intervention, Long-term mortality, LONG-TERM MORTALITY, BLOOD-CELL SUBTYPES, LYMPHOCYTE RATIO, PREDICTIVE-VALUE, ARTERY-DISEASE, URIC-ACID, NEUTROPHIL, ATHEROSCLEROSIS, ASSOCIATION, ACTIVATION
  • Erciyes University Affiliated: Yes

Abstract

Objective:

 

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

(PCI).

Methods:

 

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.

Results:

 

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

 

b0.001, pb0.001,

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.

Conclusion:

 

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.

Objective: 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-term outcomes in STEMI patients undergoing primary percutaneous coronary intervention (PCI).