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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.
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.
Abstract:
Introduction The neutrophil-to-lymphocyte ratio (NLR) is a significant predictor of cardiovascular diseases, influencing their progression and prognosis. The exact role of the NLR in acute ST-segment elevation myocardial infarction (STEMI) is unclear. We investigated the possible association between peak NLR values within the first three days after STEMI onset and in-hospital outcomes in patients undergoing primary percutaneous coronary intervention (PCI). Methods This retrospective study included 641 patients who were diagnosed with acute STEMI and treated with primary PCI for 18 months at Dr. Siyami Ersek Hospital. The NLR was calculated using the maximum values obtained during the first three days after admission. The patients were divided into quartiles according to their NLR values for further analysis of potential complications during and after hospitalization, up to a follow-up period of three months. Results Significant differences were found in factors such as age, body mass index (BMI), and length of hospital stay among these groups. Specifically, we found that in-hospital mortality rates were significantly higher in the Q4 group, and there were variations in target vessel revascularization (TVR) rates, major adverse cardiac events (MACE) rates, and other clinical outcomes. Some parameters, such as reinfarction rates and certain procedural outcomes, did not show significant differences among the groups. However, despite the differences, most of the patients achieved successful outcomes after PCI, with the best results in the low NLR group and the worst results in the high NLR group. Conclusion Higher NLR values were associated with a higher risk of unfavorable outcomes during hospitalization.
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