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Neutrophil to lymphocyte ratio as a predictor of long-term mortality in African Americans undergoing percutaneous
Shyam Poludasu1, Erdal Cavusoglu, Waqas Khan
1Division of Cardiology, Department of Medicine, State University of New York, Downstate Medical Center, Brooklyn, New York, USA.
Insights
The neutrophil-to-lymphocyte (N/L) ratio predicts long-term mortality in African Americans after percutaneous coronary intervention (PCI). A higher N/L ratio indicates increased mortality risk, establishing it as a key predictor.
Area of Science:
- Cardiology
- Hematology
- Public Health
Background:
- The neutrophil-to-lymphocyte (N/L) ratio is a known predictor of long-term mortality in patients undergoing percutaneous coronary intervention (PCI).
- Previous research indicates lower mean neutrophil counts in African Americans compared to white individuals.
- The predictive value of the N/L ratio for long-term mortality specifically in African Americans undergoing PCI remains unestablished.
Purpose of the Study:
- To investigate the utility of the neutrophil-to-lymphocyte (N/L) ratio in predicting long-term mortality among African American patients who have undergone percutaneous coronary intervention (PCI).
Main Methods:
- A cohort of 372 African American patients who underwent PCI between January 2003 and August 2005 was analyzed.
- Patients were categorized into two groups based on their N/L ratio: lower (<3.5) and higher (>=3.5).
- The primary endpoint was all-cause mortality, assessed at a median follow-up of 3.6 years.
Main Results:
- The study observed 48 deaths during the follow-up period.
- Mortality rates were significantly higher in the higher N/L ratio group (31.1%) compared to the lower N/L ratio group (10.4%) (unadjusted p < 0.001).
- The N/L ratio independently predicted long-term mortality, with a hazard ratio of 2.1 (95% CI: 1.1-4; p = 0.02) after covariate adjustment. It remained a significant predictor when analyzed categorically and continuously.
Conclusions:
- The neutrophil-to-lymphocyte (N/L) ratio serves as a potent and independent predictor of long-term mortality in African Americans undergoing percutaneous coronary intervention (PCI).
- This finding highlights the N/L ratio's clinical relevance in risk stratification for this specific demographic post-PCI.
Background:
Neutrophil to lymphocyte ratio (N/L ratio) has been shown to predict long-term mortality in patients undergoing percutaneous coronary intervention (PCI). African Americans have been shown to have lower mean neutrophil counts compared to whites. The usefulness of the N/L ratio in predicting long-term mortality in African Americans undergoing PCI is unknown.
Methods:
We evaluated a total of 372 African American patients (327 patients with lower N/L ratio [<3.5] and 45 patients with higher N/L ratio [> or =3.5]) who underwent PCI during January 2003 to August 2005. The primary endpoint was all-cause mortality at a median follow-up to 3.6 years.
Results:
During the median ( +/- SD) follow-up period of 3.6 +/- 1 years, there were a total of 48 deaths. The mortality rate was 10.4% in the group with a lower N/L ratio and 31.1% in the group with a higher N/L ratio (unadjusted p < 0.001). After adjustment for covariates with significant impact on mortality, N/L ratio was still a strong and independent predictor of long-term mortality with a hazard ratio (HR) of 2.1 (95% confidence interval [CI]: 1.1-4; p = 0.02). N/L ratio was also found to be a strong and independent predictor of long-term mortality even when analyzed as a categorical variable with 3 groups (HR of 0.39 for lower tertile compared to the upper tertile, 95% CI: 0.19-0.81; p = 0.012) and as a continuous variable (p = 0.002).
Conclusion:
N/L ratio is a powerful independent predictor of long-term mortality in African Americans undergoing PCI.