Neutrophil to Lymphocyte Ratio Predicts Left Ventricular Remodeling in Patients with ST Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention.
- Author:
Abdurrezzak BOREKCI
1
;
Mustafa GUR
;
Caner TURKOGLU
;
Ahmet Oytun BAYKAN
;
Taner SEKER
;
Durmus Yildiray SAHIN
;
Hazar HARBALIOGLU
;
Zafer ELBASAN
;
Mustafa TOPUZ
;
Murat CAYLI
Author Information
- Publication Type:Original Article
- Keywords: Myocardial infarction; Remodeling; Neutrophils, lymphocytes; BNP; No-reflow
- MeSH: Biomarkers; Creatine Kinase; Echocardiography; Humans; Incidence; Leukocyte Count; Logistic Models; Lymphocytes*; Myocardial Infarction*; Neutrophils*; Percutaneous Coronary Intervention*; Prospective Studies; Sensitivity and Specificity; Stroke Volume; Ventricular Remodeling*
- From:Korean Circulation Journal 2016;46(1):15-22
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND AND OBJECTIVES: It has been demonstrated that the neutrophil/lymphocyte ratio (NLR) might be a useful marker to predict cardiovascular risk and events. We aimed to investigate the role of the NLR to predict ventricular remodeling (VR) in patients with anterior ST-elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention. SUBJECTS AND METHODS: We prospectively included 274 consecutive anterior STEMI patients. Echocardiography was performed during admission and at six months after myocardial infarction. VR was defined as at least 20% increase from baseline in left ventricular end-diastolic volume. Patients were divided into two groups according to their VR status: VR (n=67) and non-VR (n=207). Total and differential leukocyte count, N-terminal pro-brain natriuretic peptide (NT-proBNP) and other biochemical markers were measured at admission and 24 hours later. RESULTS: Compared with the non-VR group, peak creatine kinase MB (CK-MB), NT-proBNP (24 h), neutrophil/lymphocyte ratio, presence of diabetes, no-reflow frequency and wall motion score index were significantly higher in patients with VR (p<0.05 for all). On multivariate logistic regression analysis, NLR (beta=2.000, 95% confidence interval=1.577-2.537, p<0.001) as well as peak CK-MB, NT-proBNP (24 h), WMSI and diabetes incidence were associated with VR. The cutoff value of the neutrophil/lymphocyte ratio obtained by receiver operator characteristic curve analysis was 4.25 for the prediction of VR (sensitivity: 79 %, specificity: 74%). CONCLUSION: In patients with anterior STEMI, initial NLR and NT-proBNP measured 24 hours after admission may be useful for predicting adverse cardiovascular events including left VR.
