Association of neutrophil/lymphocyte ratio with long-term mortality after ST elevation myocardial infarction treated with primary percutaneous coronary intervention.
- Author:
Xu-Hua SHEN
1
;
Qi CHEN
;
Yan SHI
;
Hong-Wei LI
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Aged; Angioplasty, Balloon, Coronary; CD4 Lymphocyte Count; Electrocardiography; Female; Humans; Lymphocytes; physiology; Male; Middle Aged; Myocardial Infarction; immunology; mortality; therapy; Neutrophils; physiology; Prognosis; Proportional Hazards Models
- From: Chinese Medical Journal 2010;123(23):3438-3443
- CountryChina
- Language:English
-
Abstract:
BACKGROUNDPrimary percutaneous coronary interventions (PCI) have been proposed as a novel superior management strategy in patients with ST elevation myocardial infarction (STEMI). This study tested the hypothesis that in the acute phase of myocardial infarction with ST-segment elevation, the neutrophil/lymphocyte (N/L) ratio is a predictor of long-term prognosis.
METHODSWe analyzed 551 consecutive STEMI patients treated with primary PCI at a single university center. Patients were stratified according to quartiles of the mean neutrophil/lymphocyte ratio.
RESULTSKaplan-Meier survival analysis showed a cumulative eight-year survival of 94.2% in the first quartile, 92.0% in the second quartile, 91.3% in the third quartile, and 75.4% in the fourth quartile (P < 0.001 by log rank). Relative to patients in the other three lower N/L ratio quartiles, patients in the highest quartile were more than four times more likely to die during hospitalization (P < 0.001) and during long-term follow-up (P < 0.001). By multivariate Cox regression analysis including baseline demographic, clinical, and angiographic covariables, the N/L ratio in the highest quartile remained an independent predictor of mortality (hazard ratio 2.38, 95% confidence interval (CI) 1.42 to 3.98; P = 0.001).
CONCLUSIONThe neutrophil/lymphocyte ratio is a strong independent predictor of long-term mortality after ST elevation myocardial infarction treated with very early revascularization.