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Utility of Neutrophil-Lymphocyte Ratio in Predicting Troponin Elevation in the Emergency Department Setting
Ahmet Korkmaz1, Abdulkadir Yildiz2, Harun Gunes3
1Department of Cardiology, Cankiri State Hospital, Cankiri, Turkey.
Insights
The neutrophil-lymphocyte ratio (NLR) can help identify patients with acute coronary syndrome likely to test positive for troponin. This simple blood test may aid early diagnosis in emergency settings.
Area of Science:
- Cardiology
- Hematology
- Emergency Medicine
Background:
- Limited data exists on the diagnostic utility of the neutrophil-lymphocyte ratio (NLR) in acute coronary syndrome (ACS).
- Accurate early diagnosis of ACS is crucial for timely intervention and improved patient outcomes.
Purpose of the Study:
- To evaluate the predictive value of NLR in differentiating patients with acute chest pain who will develop troponin positivity.
- To assess NLR as a potential early diagnostic marker in the emergency department.
Main Methods:
- A cohort of 244 patients presenting with acute chest pain was analyzed.
- Patients were categorized into troponin-positive and troponin-negative groups based on 12- to 24-hour follow-up results.
- Admission NLR levels were compared between the two groups.
Main Results:
- Admission NLR was significantly higher in the troponin-positive group (5.49 ± 4.01) compared to the troponin-negative group (2.40 ± 1.36).
- An NLR cutoff of 2.80 demonstrated 79% sensitivity and 73% specificity for predicting follow-up troponin positivity.
- Multivariate analysis identified admission NLR and glucose levels as significant predictors of troponin positivity.
Conclusions:
- Neutrophil-lymphocyte ratio (NLR) shows promise as an early diagnostic marker for acute coronary syndrome.
- NLR can aid in discriminating patients likely to have a positive troponin test, facilitating earlier management decisions.
Abstract:
There is little data regarding the diagnostic ability of neutrophil-lymphocyte ratio (NLR) in acute coronary syndrome. Therefore, we aimed to assess the predictive value of NLR in the discrimination of troponin-positive patients. We enrolled 244 patients (mean age 61.3 ± 11.7 years, 70.5% male) who presented to the emergency service with acute chest pain. Patients were divided into 2 groups based upon the troponin positivity in the 12- to 24-hour follow-up. The admission NLR was significantly higher in the troponin-positive group (5.49 ± 4.01 vs 2.40 ± 1.36, P < .001). A cutoff point of 2.80 for NLR measured on admission had 79% sensitivity and 73% specificity in predicting follow-up troponin positivity. After multivariate analysis, admission NLR and glucose levels remained significant predictors of follow-up troponin positivity. In conclusion, NLR may be an early diagnostic marker in emergency service for discriminating patients who will have a positive troponin test in the follow-up.
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