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Neutrophil-to-lymphocyte ratio as a predictor of left ventricle function and mortality in patients with myocardial
Michał Węgiel1, Kinga Glądys2, Barbara Zdzierak1,3
1Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland.
Insights
The neutrophil-to-lymphocyte ratio (NLR) can predict poor outcomes after myocardial infarction (MI). Elevated NLR indicates worse left ventricular function and higher mortality risk in MI patients, aiding long-term risk stratification.
Area of Science:
- Cardiology
- Biomarkers
- Clinical Outcomes
Background:
- Myocardial infarction (MI) significantly impacts long-term patient outcomes, including remodeling, heart failure, and mortality.
- Optimal biomarkers for risk stratification in MI patients remain debated, highlighting a need for improved predictive tools.
Purpose of the Study:
- To evaluate the neutrophil-to-lymphocyte ratio (NLR) as a potential biomarker.
- To assess the association between NLR and long-term clinical and echocardiographic outcomes following MI.
Main Methods:
- Analysis of 412 patients hospitalized for MI between 2016-2019.
- Collection of demographic, clinical, biochemical, angiographic, and echocardiographic data.
- Long-term clinical and echocardiographic follow-up of patients.
Main Results:
- NLR showed a negative correlation with baseline and follow-up left ventricular ejection fraction (LVEF).
- Elevated NLR predicted long-term reduced LVEF and all-cause mortality.
- NLR > 8.7 was associated with significantly poorer survival rates.
Conclusions:
- Elevated NLR is linked to impaired left ventricular function post-MI.
- NLR serves as a significant predictor of increased mortality in patients after myocardial infarction.
Introduction:
Myocardial infarction (MI) is a complex clinical syndrome that significantly influences long-term outcomes through its effects on myocardial remodeling, heart failure progression, and mortality. Despite extensive research, there is still no consensus regarding optimal biomarkers for risk stratification of MI patients in terms of long-term outcomes.
Aim:
The study aimed to assess neutrophil-to-lymphocyte ratio (NLR) and evaluate the association between this ratio and long-term clinical and echocardiographic outcomes in patients hospitalized for MI.
Material And Methods:
A total of 412 patients hospitalized for MI between 2016 and 2019 were screened. Demographic data, baseline clinical characteristics, typical biochemical parameters, and angiographic and echocardiographic findings were analyzed. Patients underwent long-term clinical and echocardiographic follow-up.
Results:
NLR correlated negatively with both baseline and follow-up left ventricular ejection fraction (LVEF) (r = -0.214; p = 0.043 and r = -0.3; p < 0.001, respectively). In regression analysis, NLR was a significant predictor of long-term reduced LVEF (defined as a value < 40%) (OR = 4.01; p < 0.001) as well as all-cause mortality (OR = 1.16; p = 0.008). In receiver operating characteristic (ROC) analysis, NLR demonstrated significant predictive value for mortality (AUC = 0.65; p = 0.04) with an optimal cut-off point of 8.7 (Youden index = 0.4). Kaplan-Meier analysis revealed that patients with NLR > 8.7 had significantly poorer survival compared to those with lower NLR values (p < 0.001).
Conclusions:
Elevated NLR was associated with poorer left ventricular function and increased mortality in patients after MI during long-term observation.
