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Prognostic Value of Neutrophil-to-Lymphocyte Ratio for Patients Undergoing Heart Valve Replacement
Tolga Sinan Guvenc1, Ahmet Ekmekci2, Mahmut Uluganyan3
1Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
Insights
The neutrophil-to-lymphocyte ratio (NLR) predicts adverse outcomes in coronary artery disease and mortality after valve replacement surgery. Higher NLR levels are associated with increased in-hospital and 300-day mortality post-valvular surgery.
Area of Science:
- Cardiology
- Inflammatory markers
- Surgical outcomes
Background:
- The neutrophil-to-lymphocyte ratio (NLR) is an emerging biomarker.
- NLR has shown predictive value for adverse outcomes in coronary artery disease (CAD).
- Its utility in predicting mortality after valve replacement surgery requires further investigation.
Purpose of the Study:
- To evaluate the neutrophil-to-lymphocyte ratio (NLR) as a predictor of mortality following valve replacement surgery.
- To determine the association between preoperative NLR tertiles and postoperative outcomes.
Main Methods:
- Retrospective analysis of 932 patients undergoing valve replacement surgery.
- Patients categorized into three tertiles based on preoperative neutrophil-to-lymphocyte ratio (NLR).
- Comparison of in-hospital and 300-day mortality rates across NLR tertiles.
Main Results:
- Patients in the highest NLR tertile were older and had more critical coronary artery disease.
- Higher NLR tertiles were significantly associated with increased in-hospital mortality.
- The highest NLR tertile demonstrated the highest 300-day mortality, with a significant hazard ratio.
Conclusions:
- The neutrophil-to-lymphocyte ratio (NLR) is a valuable parameter for assessing postoperative mortality risk after valvular surgery.
- Elevated NLR is a significant predictor of both in-hospital and long-term mortality.
- NLR can aid in risk stratification for patients undergoing valve replacement procedures.
Background And Aim Of The Study:
The neutrophil-tolymphocyte ratio (NLR) was found to be a predictor of adverse outcome in patients with coronary artery disease (CAD). The ratio may also be a useful marker to predict mortality following valve replacement surgery.
Methods:
A total of 932 patients was enrolled retrospectively. Patients were allocated to three tertiles based on their NLR (group 1, NLR ≤1.90; group 2, 1.90 < NLR ≤2.93; group 3, NLR >2.93).
Results:
Patients in the highest tertile were older (p = 0.049, 95% CI 0.09-5.98), tended to have chronic renal failure (p = 0.028, OR: 2.6, 95% CI 1.08-6.35), and had more frequent critical CAD on preoperative angiography (p <0.001, OR 2.1, 95% CI 1.38-3.21). Postoperatively, patients in the highest NLR tertile had a higher in-hospital mortality rate than those in the first tertile (p <0.001, OR 4.67, 95% CI 2.37-9.20) and second tertile (p = 0.002, OR 2.26, 95% CI 1.32-3.86). Patients in the third tertile had the highest mortality at day 300 (log-rank p <0.001). The hazard ratio (HR) for the second tertile was 1.8 (p = 0.11, 95% CI 0.88-3.79), and for the third tertile was 2.8 (p = 0.003, 95% CI 1.40-5.59).
Conclusions:
The NLR is a useful parameter to assess postoperative in-hospital mortality risk after valvular surgery.
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