Diagnostic and prognostic performance of the neutrophil-to-lymphocyte ratio in acute coronary syndromes: A...

Area of Science:

• Cardiology
• Inflammation Biomarkers
• Diagnostic Accuracy

Background:

• Cardiovascular disease (CVD) is a global health concern with rising incidence.
• Acute coronary syndrome (ACS) pathogenesis involves inflammation.
• Neutrophil-to-lymphocyte ratio (NLR) is a cost-effective inflammatory biomarker with potential in cardiovascular medicine.

Approach:

• A systematic meta-analysis was conducted, searching major scientific databases up to January 10, 2024.
• Included 90 articles encompassing 45,990 participants.
• Aggregated findings using normalized mean differences and 95% confidence intervals.

Key Points:

• Pooled NLR analysis revealed significant differences across ACS subtypes: STEMI vs. non-STEMI, AMI vs. unstable angina, and ACS vs. stable angina/controls.
• Elevated NLR was associated with increased ACS mortality, with lower NLR in survivors.
• NLR differentiated STEMI survivors and predicted major adverse cardiovascular events (MACE) in ACS and STEMI patients.

Conclusions:

• NLR serves as an effective tool for differentiating ACS types.
• A high NLR is linked to ACS and elevated 30-day MACE risk.
• NLR demonstrates prognostic value for MACE, especially in ST-segment elevation myocardial infarction.