The Neutrophil-to-Lymphocyte Ratio Predicts All-Cause Mortality in Patients with Implantable Cardioverter
Naoaki Hashimoto1, Takanori Arimoto1, Taro Narumi1
1Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
Insights
The neutrophil-to-lymphocyte ratio (NLR) can predict all-cause mortality in patients receiving implantable cardioverter-defibrillators (ICDs). A high NLR indicates a greater risk of death, independent of ICD shock events.
Area of Science:
- Cardiology
- Biomarkers
- Predictive Medicine
Background:
- The prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in patients with implantable cardioverter-defibrillators (ICDs) remains incompletely understood.
- ICDs are crucial for managing life-threatening arrhythmias in patients with cardiomyopathy.
Purpose of the Study:
- To investigate the association between NLR and clinical outcomes in patients with cardiomyopathy undergoing ICD implantation.
- To determine if NLR can predict all-cause mortality and/or appropriate ICD shocks.
Main Methods:
- Prospective enrollment of 120 patients with cardiomyopathy receiving ICDs.
- Measurement of NLR from blood samples obtained on the day of implantation.
- Follow-up for a median of 61.2 months to assess all-cause mortality and appropriate ICD shocks.
- Multivariate Cox regression analysis to identify independent predictors of outcomes.
Main Results:
- The neutrophil-to-lymphocyte ratio (NLR) independently predicted all-cause mortality but not appropriate ICD shocks.
- A high NLR (≥2.1) was associated with increased all-cause mortality in patients receiving ICDs for primary or secondary prevention.
- Elevated NLR correlated with death preceding an appropriate ICD shock.
Conclusions:
- The neutrophil-to-lymphocyte ratio (NLR) serves as a valuable biomarker for predicting all-cause mortality in patients with cardiomyopathy who have received ICDs.
- NLR evaluation may aid in risk stratification and personalized management strategies for this patient population.
Background:
The relationship between the neutrophil-to-lymphocyte ratio (NLR) and outcome in patients with implantable cardioverter-defibrillators (ICDs) is unclear.
Methods And Results:
Consecutive patients with cardiomyopathy who had received an ICD (n = 120, mean age 64 ± 11 years) were prospectively enrolled. Blood samples were obtained on the morning of the day of implantation. Patients were followed for a median period of 61.2 months, to an endpoint of all-cause mortality or appropriate ICD shock, which occurred in 35 (29%) and 28 (23%) patients, respectively. Multivariate Cox analysis revealed that secondary prevention was only associated with appropriate ICD shocks. The NLR, brain natriuretic peptide level, and estimated glomerular filtration rate were independent predictors of all-cause mortality but not of appropriate ICD shocks. Subgroup analysis revealed that a high NLR (≥2.1) was valuable for anticipating all-cause mortality among patients who had received ICDs for primary or secondary prevention. A high NLR was also associated with death prior to appropriate ICD shock.
Conclusion:
Evaluating the NLR may be useful for predicting outcomes in patients with cardiomyopathy who have received ICDs.
