Application of neutrophil/lymphocyte ratio in predicting coronary blood flow and mortality in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention.

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Application of neutrophil/lymphocyte ratio in predicting coronary blood flow and mortality in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention.

J Cardiol. 2015 Jul;66(1):9-14

Authors: Pan W, Zhao D, Zhang C, Li W, Yu J, Wang S, Li Z, Wang Z, Sun X, Liu H, Sun Y, Tian Y, Wang L

Abstract
BACKGROUND: To investigate the potential correlation of neutrophil/lymphocyte ratio (NLR) to coronary blood flow and in-hospital along with long-term mortality in patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI).
METHODS: In the current study, 636 consecutive patients with STEMI were recruited and stratified into three tertiles by NLRs upon admission (tertile I<3.0, tertile II 3.0-6.40, tertile III>6.40). The coronary blood flow was expressed by corrected TIMI frame count (CTFC). The in-hospital mortality and 12-month long follow-up data were collected. Receiver operating characteristic (ROC) curves were also constructed.
RESULTS: Our analysis demonstrated that NLR was positively correlated to CTFC and in-hospital mortality (r=0.517, p<0.001; r=0.439, p<0.001). In the multiple logistic regression analysis, NLR was testified as an independent risk factor for coronary blood flow after PCI and in-hospital mortality [odds ratio (OR)=2.031, 95% confidence interval (CI): 1.627-2.435, p<0.001; OR=1.176, 95% CI: 1.025-1.351, p=0.021]. During the 12-month follow-up, there were a total of 43 deaths and statistically significant increase in long-term mortality was observed in patients from tertile I to III (p=0.005). In the ROC curves analysis, the area under the curve (AUC=0.607, 95% CI: 0.475-0.739, p=0.253), with threshold value of 5.9 (sensitivity: 63.7%, specificity: 61.1%) for predicting in-hospital mortality.
CONCLUSIONS: NLR, an indicator that can be tested in the laboratory with low cost and time consumption, is independently correlated to coronary blood flow and acts as an independent risk factor for in-hospital mortality in patients with STEMI undergoing PCI.

PMID: 25560801 [PubMed - indexed for MEDLINE]

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