The neutrophil-to-lymphocyte ratio was an independent predictor of spontaneous reperfusion (OR 0.799) and major adverse cardiac events (HR 1.035) in patients with ST-segment elevation myocardial infarction.
Cohort (n=506)
No
Does the neutrophil-to-lymphocyte ratio predict spontaneous reperfusion and major adverse cardiovascular events in patients with STEMI undergoing primary PCI?
In patients with STEMI undergoing primary PCI, a higher neutrophil-to-lymphocyte ratio is associated with a lower likelihood of spontaneous reperfusion and an increased risk of long-term major adverse cardiovascular events.
Odds Ratio: 0.799 (95% CI 0.73–0.874)
p-value: p=<0.001
Abstract Background Neutrophil to lymphocyte ratio (NLR) has emerged as a new inflammation marker, which plays a major role in plaque instability, rupture, and erosion, and facilitates its progression, leading to acute myocardial infarction. The study aims to explore the role of NLR in predicting spontaneous reperfusion (SR) and prognosis in patients with ST-segment elevation myocardial infarction (STEMI). Methods This was a retrospective analysis including 506 STEMI patients undergoing primary percutaneous coronary intervention treatment, who were divided into two groups according to the thrombolysis in myocardial infarction (TIMI) flow: SR group (69 patients, initial TIMI flow 3) and No-SR group (437 patients, initial TIMI flow 0-2). Results The incidence of SR was 13.6%. SR group was associated with a remarkably lower level of NLR 5.14 (2.97, 7.02) vs. 8.03 (4.54, 10.92), P<0.001, more proportions of final TIMI 3 flow (98.6% vs. 91.5%, P < 0.05), lower incidence of congestive heart failure (8.7% vs. 18.5%, P < 0.05), and significantly better outcomes. Using multivariate logistic regression analysis, NLR (OR: 0.799, 95% CI: 0.730-0.874, P < 0.001) and fasting blood glucose were the independent predictors of SR. On multivariate Cox regression analysis, NLR (HR: 1.035, 95% CI: 1.001-1.071, P < 0.05) was the independent predictor of MACEs during follow-up. Conclusions NLR had the ability in predicting SR in STEMI patients and SR flow was associated with a favorable outcome. We also revealed an association between NLR and increased risk of MACEs during follow-up. Clinical Perspective What Is New? The incidence of spontaneous reperfusion was 13.6%. Patients with spontaneous reperfusion had a remarkably low level of NLR 5.14 (2.97, 7.02) versus 8.03 (4.54, 10.92), P<0.001, more proportions of final TIMI 3 flow (98.6% versus 91.5%, P < 0.05), lower incidence of congestive heart failure (8.7% versus 18.5%, P < 0.05), and favorable outcomes. NLR was not only an independent predictor of spontaneous reperfusion, but also was the independent predictor of major adverse cardiac events during follow-up (HR: 1.035, 95% CI: 1.001-1.071, P < 0.05) in patients with ST-segment elevation myocardial infarction. What Are the Clinical Implications? The level of neutrophil to lymphocyte ratio in patients with ST-segment elevation myocardial infarction is associated with low occurrence of spontaneous reperfusion and adverse outcomes, although, the patients received primary percutaneous coronary intervention. Neutrophil to lymphocyte ratio the plays a major role in the risk classification of patients with ST-segment elevation myocardial infarction.
Li et al. (Wed,) conducted a cohort in ST-segment elevation myocardial infarction (n=506). Neutrophil-to-lymphocyte ratio (NLR) vs. Lower NLR was evaluated on Spontaneous reperfusion (SR) (OR 0.799, 95% CI 0.730-0.874, p=<0.001). The neutrophil-to-lymphocyte ratio was an independent predictor of spontaneous reperfusion (OR 0.799) and major adverse cardiac events (HR 1.035) in patients with ST-segment elevation myocardial infarction.