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Predictive value of neutrophil to lymphocyte ratio and red cell distribution width on death for ST segment elevation
Guoli Lin1, Caizhi Dai2, Kaizu Xu2
1Department of Cardiology, The Affiliated Hospital of Putian University, Putian University, No. 999 Dongzhen East Road, Licheng District, Putian, 351100, Fujian, China. 289055041@qq.com.
Insights
Neutrophil to lymphocyte ratio (NLR) and red cell distribution width (RDW) can predict long-term mortality in patients with ST-segment elevation myocardial infarction (STEMI) after emergency percutaneous coronary intervention (PCI). These simple blood markers offer valuable prognostic information for primary hospitals.
Area of Science:
- Cardiology
- Hematology
- Clinical Medicine
Background:
- Predicting mortality in ST-segment elevation myocardial infarction (STEMI) is crucial for patient management.
- Existing clinical scoring criteria are often complex and not readily applicable in primary care settings.
- Neutrophil to lymphocyte ratio (NLR) and red cell distribution width (RDW) are accessible hematological parameters.
Purpose of the Study:
- To investigate the predictive value of combining NLR and RDW for long-term mortality in STEMI patients undergoing emergency percutaneous coronary intervention (PCI).
- To assess the utility of these simple blood markers in risk stratification for STEMI patients.
Main Methods:
- A cohort of 181 STEMI patients who underwent emergency PCI was studied.
- Clinical data and long-term prognosis, including cardiovascular death, were collected.
- Statistical analyses included binary logistic regression and Kaplan-Meier survival analysis.
Main Results:
- NLR and RDW were significantly higher in the cardiovascular death group compared to the survival group (P < 0.01).
- Both NLR (OR=1.122, P=0.003) and RDW (OR=1.288, P=0.0005) were identified as independent predictors of mortality.
- Kaplan-Meier analysis demonstrated an increased risk of death with rising NLR levels (P < 0.001).
Conclusions:
- NLR and RDW are independent predictors of cardiovascular death in STEMI patients post-PCI.
- These hematological indices offer valuable prognostic information, potentially aiding risk assessment in primary care.
- The combination of NLR and RDW may enhance the prediction of long-term outcomes in STEMI.
Abstract:
There are many clinical scoring criteria for predicting the risk of death in patients with acute ST-segment elevation myocardial infarction (STEMI), but most of the indicators are complex to calculate and are not suitable for use in primary hospitals. Neutrophil to lymphocyte ratio (NLR) and red cell distribution width (RDW) are blood routine indicators that are easy to obtain and may help primary hospitals to evaluate the risk of death in patients with STEMI. Our aim was to explore the predictive value of NLR combined with RDW in the long-term prognosis of patients with STEMI after emergency percutaneous coronary intervention (PCI). A total of 181 patients with STEMI who underwent emergency PCI in the Affiliated Hospital of Pu-tian University from January 2017 to August 2018 were selected. Clinical profile, prognosis of all patients were collected. P value < 0.05 was considered significant. In all patients, cardiovascular death during the follow-up period was defined as cardiovascular death group, and surviving during the follow-up period was defined as survival group. There were no significant differences in demography and comorbidities between the two groups. The differences between the two groups in NLR, RDW, C-reactive protein, N-terminal-pro B type natriuretic peptide were statistically significant (P < 0.01). Binary logistic regression analysis showed that NLR (OR = 1.122, 95% CI 1.041 ~ 1.210, P = 0.003) and RDW (OR = 1.288, 95% CI 1.126 ~ 1.472, P = 0.0005) were important predictors of mortality in patients with STEMI (P < 0.05). Kaplan-Meier analysis showed that as the NLR increased, the risk of death increased (P < 0.001). In conclusion, NLR and RDW are independent predictors of cardiovascular death in patients with STEMI, and they have a certain predictive value.
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