PREDICTIVE VALUE OF ELEVATED NEUTROPHIL TO LYMPHOCYTE RATIO IN PATIENTS UNDERGOING PRIMARY ANGIOPLASTY FOR STEMI

Abstract

Background Leukocytes total count is an independent risk marker for cardiovascular events. The ratio between neutrophils and lymphocytes counts (NLR) has been investigated as a new predictor for cardiovascular risk. We hypothesized that admission NLR would be predictive of adverse outcomes after primary angioplasty for ST-segment elevation myocardial infarction (STEMI).

Methods 2410 consecutive STEMI patients (mean age 56.2 ± 11.7 years, 2015 male, 395 female) undergoing primary angioplasty were retrospectively enrolled into the present study. The study population was divided into tertiles based on admission NLR values. A high NLR (n=803) was defined as a value in the third tertile (>6.97), and a low NLR (n=1607) was defined as a value in the lower two tertiles (≤6.97). The median follow-up time was 21 months. Clinical characteristics, in-hospital and long-term outcomes of primary angioplasty were analysed.

Results High NLR group had significantly higher incidence of in-hospital cardiovascular mortality and advanced heart failure than low NLR group (5 % vs 1.4%, p<0.001; 17.1% vs 9.9%, p<0.001, respectively). The median follow-up time was 21 months. Long-term cardiovascular mortality and advanced heart failure rates were significantly higher in patients with high NLR. (7% vs 4.8 %, p=0.02; 11.4 % vs 7.3%, p=0.002, respectively). By multivariate logistic regression analysis; high admission NLR (>6.97) was found a powerful independent predictor of in-hospital cardiovascular mortality (odds ratio: 2.8, 95% confidence interval: 1.37–5.74, p=0.005).

Conclusions These results suggest that high admission NLR level is associated with increased in-hospital and long-term cardiovascular mortality in patients with STEMI undergoing primary angioplasty.