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Predictive and prognostic value of admission neutrophil-to-lymphocyte ratio in patients with CHD
1Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No197 Ruijin Er Road, 200025, Shanghai, China.
Insights
The admission neutrophil-to-lymphocyte (N/L) ratio is linked to a higher risk of coronary heart disease (CHD). An elevated N/L ratio predicts both in-hospital and long-term adverse cardiac events in CHD patients.
Area of Science:
- Cardiology
- Hematology
- Biomarkers
Background:
- Coronary heart disease (CHD) remains a leading cause of mortality worldwide.
- Identifying reliable early biomarkers for CHD risk stratification is crucial.
- The neutrophil-to-lymphocyte (N/L) ratio is an accessible inflammatory marker.
Purpose of the Study:
- To investigate the association between the admission N/L ratio and CHD, including acute coronary syndrome (ACS) and stable angina (SA).
- To evaluate the N/L ratio's clinical utility in predicting in-hospital and long-term adverse events in CHD patients.
Main Methods:
- 942 patients were categorized into CHD (ACS, SA) and normal groups.
- Logistic regression analyzed the N/L ratio's relationship with CHD, ACS, Gensini score, and multivessel lesions.
- ROC curve analysis assessed diagnostic and prognostic value; MACEs were compared across N/L ratio quartiles during hospitalization and a 4.26-year follow-up.
Main Results:
- Elevated admission N/L ratio significantly increased CHD risk (OR=1.697) and ACS risk (OR=1.652).
- The N/L ratio demonstrated superior predictive value compared to White Blood Cell (WBC) and LDL-C.
- Higher N/L ratios correlated with increased in-hospital and long-term Major Adverse Cardiac Events (MACEs), including mortality and heart failure.
Conclusions:
- The admission N/L ratio is significantly associated with CHD.
- Elevated N/L ratio serves as a valuable predictor for adverse prognosis in patients with CHD.
Background And Aim:
The aim of this study was to examine the association between the admission neutrophil-to-lymphocyte ratio (N/L ratio) with coronary heart disease (CHD), separately from acute coronary syndrome (ACS) and stable angina (SA). A further aim was to investigate the clinical value of the N/L ratio in predicting in-hospital CHD events and the long-term prognosis of patients with CHD.
Patients And Methods:
In all, 942 patients were enrolled and classified into a CHD group (comprising an ACS group and an SA group) and a normal group. Laboratory data including regular blood test results were obtained at baseline. The relationship between the N/L ratio and CHD, ACS, Gensini score, and multivessel lesions was analyzed by logistic regression. Receiver operating characteristics (ROC) curve analysis was used to identify the value of the N/L ratio in the diagnosis of CHD, ACS, and the severity of CHD. We divided the patients into four groups according to the N/L ratio quartiles and compared the differences in major adverse cardiac events (MACEs) that occurred in hospital and in the 4.26 ± 0.57-year follow-up out of hospital.
Results:
Patients with an elevated N/L ratio had a significantly increased risk of CHD [odds ratio (OR) = 1.697, 95 % confidence interval (CI) = 1.483-1.942], and an elevated N/L ratio was closely related to a higher risk of ACS (OR = 1.652, 95 % CI = 1.434-1.902). The admission N/L ratio (0.664; 95 % CI = 1.942-1.616) showed a greater ROC area than the WBC and LDL-C values. Patients with a higher N/L ratio in both the SA group and the ACS group had a higher incidence of in-hospital and out-of-hospital MACEs, including long-term mortality and occurrence of new-onset heart failure or re-occurrence of heart failure. An elevated N/L ratio on admission was also found to be a significant indicator of 4.26-year MACEs.
Conclusion:
The admission N/L ratio was significantly associated with CHD and may become a risk predictor in the prognosis of patients with CHD.
