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Predictive Value of Neutrophil-Lymphocyte Ratio for Long-Term Cardiovascular Event Following Coronary Artery Bypass

Orcun Gurbuz1, Gencehan Kumtepe1, Hakan Ozkan2

  • 1Meddem Hospital Department of Cardiovascular Surgery Isparta Turkey Department of Cardiovascular Surgery, Meddem Hospital, Isparta, Turkey.

Brazilian Journal of Cardiovascular Surgery
|June 18, 2020
PubMed

Insights

Preoperative neutrophil-lymphocyte ratio (NLR) predicts long-term adverse cardiac and cerebrovascular events after coronary artery bypass grafting (CABG). Elevated NLR is an independent predictor of these events, regardless of EuroSCORE risk.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Biomarkers

Background:

  • Major adverse cardiac and cerebrovascular events (MACCE) are critical outcomes following coronary artery bypass grafting (CABG).
  • The predictive value of preoperative neutrophil-lymphocyte ratio (NLR) for long-term MACCE after CABG requires further elucidation.

Purpose of the Study:

  • To investigate the predictive capability of preoperative neutrophil-lymphocyte ratio (NLR) for long-term MACCE in patients undergoing CABG.
  • To determine if NLR is an independent predictor of MACCE across different EuroSCORE risk strata.

Main Methods:

  • Retrospective analysis of 751 patients undergoing elective CABG (January 2008 - January 2010).
  • Patients stratified by preoperative NLR quartiles.
  • Follow-up for 7.8 years to assess MACCE (myocardial infarction, percutaneous coronary intervention, stroke, cardiovascular mortality).

Main Results:

  • Overall MACCE rate was 11.6%.
  • Higher NLR quartiles were significantly associated with increased long-term myocardial infarction, percutaneous coronary intervention, stroke, and cardiovascular mortality (P<0.001 to P=0.005).
  • Multivariate analysis confirmed NLR as an independent predictor of MACCE (OR 1.087; P=0.004), irrespective of EuroSCORE risk groups. ROC analysis identified an NLR cut-off of 4.32.

Conclusions:

  • Neutrophil-lymphocyte ratio (NLR) serves as a valuable and accessible biomarker for predicting long-term MACCE post-CABG.
  • NLR's predictive utility is independent of the established EuroSCORE risk assessment tool.
Abstract

Keywords:
Coronary Artery BypassLymphocytesMyocardial InfarctionNeutrophilsPercutaneous Coronary InterventionStroke

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