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Prediction of Long-Term Mortality Based on Neutrophil-Lymphocyte Ratio After Percutaneous Coronary Intervention
Sam Cheol Kim1, Kyung-Hoon Sun2, Dong-Hyun Choi3
1Department of Family Medicine, Chosun University Hospital, Dong-Gu, Gwangju, South Korea.
Insights
High neutrophil-lymphocyte ratio (NLR) predicts cardiac death after percutaneous coronary intervention (PCI). This finding is particularly relevant for patients with heart failure or myocardial injury, highlighting NLR as a key prognostic indicator.
Area of Science:
- Cardiology
- Biomarkers in Cardiovascular Disease
Background:
- Preprocedural neutrophil-lymphocyte ratio (NLR) is linked to adverse outcomes in coronary artery disease.
- High NLR may predict cardiac death post-percutaneous coronary intervention (PCI).
Purpose of the Study:
- To assess the association of NLR, hs-cTnT, and NT-proBNP with cardiac death after PCI.
- To determine if high NLR is a predictor of cardiac mortality following PCI.
Main Methods:
- Analyzed NLR, hs-cTnT, and NT-proBNP in 372 patients undergoing PCI.
- Cardiac death was the primary endpoint, with a median follow-up of 25.8 months.
Main Results:
- A NLR cutoff of 3.3 showed 85.7% sensitivity and 59.3% specificity for cardiac death.
- Patients with higher NLR (≥3.3) had a significantly higher cardiac death rate (11.1% vs. 1.4%, P < 0.0001).
- Elevated NLR was more predictive in patients with heart failure (NT-proBNP ≥ 300ng/L) or myocardial injury (hs-cTnT ≥ 100ng/L).
Conclusions:
- High preprocedural NLR predicts cardiac death after PCI.
- NLR is a valuable prognostic marker, especially in PCI patients with coexisting heart failure or myocardial injury.
Background:
The preprocedural neutrophil-lymphocyte ratio (NLR) is related to adverse outcomes in patients with coronary artery disease. We hypothesized that high NLR is a predictor of cardiac death after percutaneous coronary intervention (PCI). The objective of this investigation was to assess the associations of NLR, high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B type natriuretic peptide (NT-proBNP) with the occurrence of cardiac death after PCI.
Materials And Methods:
The NLR, hs-cTnT and NT-proBNP were analyzed in 372 patients who underwent PCI. The primary end point was cardiac death.
Results:
The median NLR was 2.3 (interquartile range: 1.5-4.1). There were 21 cardiac death events during a mean follow-up duration of 25.8 months. With the NLR cutoff level set to 3.3 using the receiver-operating characteristic curve, the sensitivity and specificity for differentiating between the group with cardiac death and the group without cardiac death were 85.7% and 59.3%, respectively. Kaplan-Meier analysis revealed that the higher NLR group (≥3.3) had a significantly higher cardiac death rate than the lower NLR group (<3.3) (11.1% versus 1.4%, log-rank: P < 0.0001). This value was more useful in patients with heart failure (NT-proBNP ≥ 300ng/L) or myocardial injury (hs-cTnT ≥ 100ng/L).
Conclusions:
The outcomes of the current study demonstrate that high NLR is a predictor of cardiac death after PCI, especially in patients with heart failure or myocardial injury.
