Key result
Elevated admission NLR is linked to higher peak CK-MB levels in AMI patients.
Why the study?
Although NLR is a prognostic marker in AMI and infarct size correlates with outcomes, whether elevated admission NLR is associated with larger infarct size and higher peak CK and CK-MB levels was not clearly established.
Observational (n=170)
No
Elevated neutrophil-to-lymphocyte ratio (NLR) at admission is independently associated with higher peak CK and CK-MB levels in patients with acute myocardial infarction, highlighting its potential as an early, accessible biomarker of infarct size.
Answers are grounded in this paper and cite their sources.
Elevated admission NLR was associated with larger enzymatic infarct size in AMI; hypothesis-generating for risk stratification pending prospective validation.
The neutrophil-to-lymphocyte ratio (NLR) has emerged as a marker of systemic inflammation and a prognostic indicator in acute myocardial infarction (AMI). Simultaneously, infarct size (reflected by peak serum levels of creatine kinase (CK) and creatine kinase-myocardial band [CK-MB]) correlates with clinical outcomes in AMI. Given the inflammatory nature of infarction, elevated NLR at admission may contribute to larger infarct size and higher CK and CK-MB levels; however, this association has not been clearly established. We retrospectively analyzed data from 170 patients hospitalized for AMI. Univariate and multivariate linear regression analyses were conducted to examine associations between peak creatine kinase (peak CK) and CK-MB levels and clinical variables, including age, sex, body mass index, hemoglobin, creatinine, uric acid, B-type natriuretic peptide, albumin, C-reactive protein, mean blood pressure, NLR, and platelet-to-lymphocyte ratio at admission. Structural equation modeling was also employed to explore the relationship between NLR and infarct size. Multivariate analysis revealed a significant positive association between NLR at admission and both peak CK (β = 0.342, P = .002) and peak creatine kinase-myocardial band (β = 0.352, P = .001). Structural equation modeling confirmed these findings, showing significant correlations between NLR and peak CK (β = 0.342, P = .001) and CK-MB (β = 0.352, P < .001). Elevated NLR at admission is significantly associated with increased peak CK and CK-MB levels in patients with AMI, suggesting a potential link between systemic inflammation and infarct size. NLR may serve as an early, accessible predictor of infarct magnitude following AMI.
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Shirasaki et al. (2025) conducted an observational in Acute myocardial infarction (AMI) (n=170). Neutrophil-to-lymphocyte ratio (NLR) vs. Continuous variable was evaluated on Peak creatine kinase-myocardial band (CK-MB) levels (β = 0.352, p=0.001). Elevated neutrophil-to-lymphocyte ratio at admission was significantly associated with increased peak CK (β = 0.342, p=0.002) and peak CK-MB levels (β = 0.352, p=0.001) in AMI patients.
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