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Predicting outcome after percutaneous balloon mitral commissurotomy : Role of neutrophil-lymphocyte ratio
A Separham1, L Pourafkari1,2, H Bodagh1
1Cardiovascular Research Center, Tabriz University of Medical Science, Tabriz, Iran.
Background:
The value of the neutrophil-lymphocyte ratio (NLR) along with the severity of mitral stenosis (MS) in predicting the outcome of percutaneous balloon mitral commissurotomy (PBMC) has not been studied.
Patients And Methods:
Patients with severe MS undergoing PBMC between 2013 and 2014 in a university hospital were prospectively enrolled. Complete blood cell count was obtained upon admission and NLRs were calculated. The correlations between NLR with immediate PBMC success and restenosis in 1 year were evaluated.
Results:
In all, 102 patients (80 women) with a mean age of 44.5 ± 13.1 years were enrolled in the study. NLR on admission was 2.6 ± 0.8 and mitral valve area (MVA) was 0.89 ± 0.18 cm2. Patients with a lower MVA at baseline had a higher NLR (p = 0.016). The rate of immediate success was 63 % for PBMC. There was no difference in NLR between patients with regard to early and late failures, as well as those who developed restenosis of the valve. Smaller valve area and the rate of valvular dilatation during PBMC were the only independent factors that predicted early and late failure, respectively.
Conclusion:
NLR at the time of treatment was not useful in predicting procedural outcome or restenosis during follow-up of patients undergoing PBMC.
Insights
The neutrophil-lymphocyte ratio (NLR) does not predict outcomes for percutaneous balloon mitral commissurotomy (PBMC). Mitral valve area and dilatation are key predictors of PBMC success and restenosis.
Area of Science:
- Cardiology
- Interventional Cardiology
- Inflammatory Markers
Background:
- Severe mitral stenosis (MS) poses treatment challenges.
- Predictive markers for percutaneous balloon mitral commissurotomy (PBMC) outcomes are valuable.
- The role of neutrophil-lymphocyte ratio (NLR) in PBMC has not been established.
Purpose of the Study:
- To investigate the predictive value of NLR in patients undergoing PBMC.
- To correlate NLR with immediate procedural success and long-term restenosis.
- To assess the relationship between NLR and mitral valve area (MVA) severity.
Main Methods:
- Prospective enrollment of 102 patients with severe MS undergoing PBMC.
- Calculation of NLR from complete blood cell counts on admission.
- Evaluation of correlations between NLR, immediate PBMC success, and 1-year restenosis.
Main Results:
- A higher NLR was associated with a smaller baseline MVA (p=0.016).
- The overall immediate PBMC success rate was 63%.
- NLR did not differ between patients with successful or failed procedures or those who developed restenosis.
Conclusions:
- NLR on admission is not a useful predictor of PBMC procedural success.
- NLR does not predict restenosis in patients undergoing PBMC for mitral stenosis.
- Baseline MVA and procedural dilatation are independent predictors of PBMC outcomes.
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