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Neutrophil to lymphocyte ratio (NLR) and cardiovascular diseases: an update
1a Division of Cardiovascular Medicine , St. Elizabeth's Medical Center, Tufts University School of Medicine , Boston , MA , USA.
Insights
The neutrophil to lymphocyte ratio (NLR) is a valuable inflammatory marker for predicting cardiovascular disease outcomes. Higher NLR levels indicate increased risk for cardiac events, mortality, and heart failure, offering significant prognostic value.
Area of Science:
- Cardiovascular Medicine
- Inflammation Research
- Biomarker Discovery
Background:
- Inflammatory and oxidative stress are key factors in cardiovascular disease pathogenesis.
- Investigating inflammatory markers is crucial for understanding and managing cardiovascular conditions.
- The neutrophil to lymphocyte ratio (NLR) has emerged as a significant inflammatory marker.
Purpose of the Study:
- To review the prognostic role of the neutrophil to lymphocyte ratio (NLR) in cardiovascular disease.
- To highlight NLR's utility as a cost-effective and accessible biomarker.
- To underscore NLR's predictive capabilities for clinical outcomes and risk stratification.
Main Methods:
- Literature review of studies investigating the neutrophil to lymphocyte ratio (NLR) in cardiovascular disease.
- Analysis of NLR's correlation with established cardiovascular risk scores (GRACE, SYNTAX).
- Evaluation of NLR's association with clinical outcomes like mortality, arrhythmias, and heart failure.
Main Results:
- Elevated NLR predicts cardiac arrhythmias and short- and long-term mortality in acute coronary syndromes (ACS).
- Higher NLR is linked to increased risk of congestive heart failure decompensation and mortality.
- NLR demonstrates prognostic value in patients undergoing transaortic valve replacement and in valvular heart disease progression.
Conclusions:
- The neutrophil to lymphocyte ratio (NLR) is a powerful, inexpensive prognostic biomarker in cardiovascular medicine.
- NLR offers immediate clinical predictability and aids in risk stratification for various cardiovascular conditions.
- NLR is experiencing a resurgence due to its cost-effectiveness and significant clinical utility.
Abstract:
As we know, inflammatory and oxidative stresses have a role in the pathogenesis of cardiovascular disease. This knowledge has triggered many investigations targeted to inflammatory markers. One such example, the neutrophil to lymphocyte ratio (NLR), is an inexpensive and easily accessible inflammatory marker whose role in cardiovascular disease has been studied extensively in the past few years. The neutrophil lymphocyte ratio has been shown to predict cardiac arrhythmias as well as short- and long-term mortality in patients with acute coronary syndromes (ACS). It has correlated well with ACS risk prediction models such as the GRACE and SYNTAX scores. A higher NLR has also been associated with frequent congestive heart failure decompensation and long-term mortality. The neutrophil to lymphocyte ratio also appears to have a prognostic role in patients undergoing transaortic valve replacement and the progression of valvular heart diseases. Despite the science of inflammatory biomarkers having been described decades ago, NLR appears to be enjoying a renaissance as a cost-effective biomarker with immediate clinical predictability and prognostication.
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