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The relationship between neutrophil/lymphocyte ratio and the TIMI flow grade in patients with STEMI undergoing
1Adana Numune Training and Research Hospital, Adana, Turkey. cemrec76@hotmail.com.
Insights
The neutrophil-to-lymphocyte ratio is a key indicator for predicting no-reflow after ST-elevation myocardial infarction (STEMI) treatment. This easily measured blood marker can help identify patients at higher risk for poor outcomes following primary percutaneous coronary intervention (PCI).
Area of Science:
- Cardiology
- Hematology
- Interventional Cardiology
Background:
- ST-segment elevation myocardial infarction (STEMI) significantly contributes to cardiovascular morbidity and mortality.
- Coronary no-reflow is a critical complication following primary percutaneous coronary intervention (PCI) in STEMI patients, impacting prognosis.
- Identifying predictors of no-reflow is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the association between specific hematologic parameters and the occurrence of coronary no-reflow after primary PCI in STEMI patients.
- To evaluate the diagnostic value of the neutrophil-to-lymphocyte (N/L) ratio in predicting no-reflow post-PCI.
Main Methods:
- A cohort of 145 STEMI patients admitted within 6 hours of symptom onset were enrolled.
- Patients were categorized based on Thrombolysis In Myocardial Infarction (TIMI) flow grade post-PCI, defining no-reflow as TIMI Flow Grade 0-2.
- Baseline hematologic parameters, including the N/L ratio, were analyzed and compared between groups.
Main Results:
- The neutrophil-to-lymphocyte (N/L) ratio was significantly elevated in STEMI patients compared to healthy controls (7.1±4.6 vs. 2.3±1.7, p < 0.001).
- A significantly higher N/L ratio was observed in patients experiencing no-reflow (TIMI Flow Grade 0-2) compared to those with successful reflow (TIMI Grade 3) (13.1±4.5 vs. 5.3±2.7, p < 0.001).
- Fasting glucose, BUN, and creatinine levels did not differ significantly between the groups.
Conclusions:
- The neutrophil-to-lymphocyte (N/L) ratio is an independent predictor of post-primary PCI coronary no-reflow in STEMI patients.
- The N/L ratio represents a cost-effective and readily available laboratory marker for assessing no-reflow risk.
- This finding may aid in risk stratification and management strategies for STEMI patients undergoing PCI.
Objectives:
ST segment elevation myocardial infarction (STEMI) is an important cause of the morbidity and mortality in coronary artery disease. The aim of this study is to investigate the relationship between hematologic parameters and post primary PCI coronary no-reflow.
Patients And Methods:
A total of 145 consecutive STEMI patients (mean age=58.2±12.3 years) and healthy volunteer admitted within 6 hours from symptom onset were enrolled to the study in the cardiology clinics. The STEMI patients were divided into 2 groups based on the Thrombolysis In Myocardial Infarction (TIMI) flow grade. No-reflow was defined as post-PCI TIMI Flow Grade 0, 1 or 2 and angiographic success was defined as TIMI Grade 3 Flow.
Results:
Diabetes mellitus hypertension and smoking status were similar between groups. With respect to baseline laboratory status, fasting glucose, blood urea nitrogen, creatinine levels were not significantly different between groups. The neutrophil/lymphocyte (N/L) ratio was also significantly higher in STEMI group (7.1±4.6 vs. 2.3±1.7, p < 0.001). Additionally, N/L ratio was also significantly higher in No-reflow group (TIMI Flow Grade 0, 1 or 2) group (13.1±4.5 vs. 5.3±2.7, p < 0.001).
Conclusions:
The N/L ratio, which is cheaply and easily measurable laboratory data is independently associated with post primary PCI coronary no-reflow.
