The Impact of the Neutrophil-to-Lymphocyte Ratio on In-Hospital Outcomes in Patients With Acute ST-Segment Elevation

Gürkan Karaca1, Ahmet Ekmekci1, Ali Kimiaei1

  • 1Cardiology, Bahçeşehir University, Istanbul, TUR.

Cureus
|February 20, 2024
PubMed

Insights

The neutrophil-to-lymphocyte ratio (NLR) predicts outcomes in ST-segment elevation myocardial infarction (STEMI). Higher peak NLR values within three days post-STEMI correlate with increased in-hospital mortality and adverse events after primary PCI.

Area of Science:

  • Cardiology
  • Hematology
  • Clinical Medicine

Background:

  • The neutrophil-to-lymphocyte ratio (NLR) is a recognized biomarker for cardiovascular diseases.
  • The prognostic significance of NLR in acute ST-segment elevation myocardial infarction (STEMI) requires further elucidation.

Purpose of the Study:

  • To investigate the association between peak neutrophil-to-lymphocyte ratio (NLR) values and in-hospital outcomes.
  • To evaluate the relationship between NLR and complications in STEMI patients undergoing primary percutaneous coronary intervention (PCI).

Main Methods:

  • Retrospective analysis of 641 STEMI patients treated with primary PCI.
  • Calculation of peak NLR within the first three days post-admission.
  • Stratification of patients into quartiles based on NLR values for outcome analysis.

Main Results:

  • Higher NLR quartiles were associated with increased in-hospital mortality.
  • Significant variations observed in major adverse cardiac events (MACE) and target vessel revascularization (TVR) rates across NLR groups.
  • While most patients had successful PCI outcomes, higher NLR correlated with worse clinical results.

Conclusions:

  • Elevated peak NLR levels post-STEMI indicate a higher risk of adverse in-hospital outcomes.
  • NLR serves as a valuable prognostic marker in STEMI patients undergoing primary PCI.
  • Lower NLR values are associated with more favorable outcomes following STEMI and PCI.