Key result
A high neutrophil-to-lymphocyte ratio was independently associated with an increased risk of in-hospital acute heart failure in patients with STEMI (HR 2.928) and NSTEMI (HR 2.336).
Why the study?
The study was conducted to evaluate the relationship between the neutrophil-to-lymphocyte ratio and both in-hospital and long-term heart failure risk in patients with acute myocardial infarction.
Does a high neutrophil-to-lymphocyte ratio predict in-hospital acute heart failure and arrhythmia in patients with acute myocardial infarction?
Cohort (n=990)
No
Does a high neutrophil-to-lymphocyte ratio predict in-hospital acute heart failure and arrhythmia in patients with acute myocardial infarction?
Hazard Ratio: 2.928 (95% CI 1.393–6.158)
p-value: p=0.005
An elevated neutrophil-to-lymphocyte ratio at admission is an independent predictor of in-hospital acute heart failure and arrhythmia in patients with acute myocardial infarction, but does not predict long-term heart failure.
May inform in-hospital monitoring of AMI patients; leaves open long-term HF risk prediction and requires prospective validation.
Background This study was to probe into the relationship between the neutrophil-to-lymphocyte ratio (NLR) and both in-hospital and long-term heart failure risk in patients with acute myocardial infarction (AMI). Methods 990 patients with AMI, including 386 with non-ST-segment elevation myocardial infarction (NSTEMI) and 604 with segment elevation myocardial infarction (STEMI) were recruited between January 2019 and March 2022. The in-hospital acute heart failure (AHF) and arrhythmia events were recorded. Results The NLR was significantly greater in the AHF group in STEMI and NSTEMI patients, with a higher frequency of arrhythmia in comparison to the non-AHF group. A high NLR was related to a high level of myocardial injury markers, accompanied with more AHF and arrhythmia events. Multivariate logistic regression analyses revealed that high NLR is independently linked with increased in-hospital AHF and arrhythmia risk. Receiver operating characteristic curve analyses revealed that the prognostic value of NLR for in-hospital AHF was 0.704 in STEMI patients and 0.766 in NSTEMI patients. However, during a median follow-up of 28 months with 32 heart failure patients, there was no significant difference between the low NLR group ( n = 18) and the high NLR group ( n = 14). Further analysis showed that the two groups did not significantly differ in the occurrence of heart failure within 12 months of discharge. Conclusion Our results indicate that NLR is an independent risk factor of in-hospital AHF in AMI patients. However, NLR has no value in predicting long-term heart failure.
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Zhang et al. (2023) conducted a cohort in Acute myocardial infarction (STEMI and NSTEMI) (n=990). High neutrophil-to-lymphocyte ratio (NLR) vs. Low neutrophil-to-lymphocyte ratio (NLR) was evaluated on In-hospital acute heart failure (STEMI patients) (HR 2.928, 95% CI 1.393-6.158, p=0.005). A high neutrophil-to-lymphocyte ratio was independently associated with an increased risk of in-hospital acute heart failure in patients with STEMI (HR 2.928) and NSTEMI (HR 2.336).
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