Relationship Between Admission Neutrophilto- Lymphocyte Ratio and in-Hospital Mortality in Acute Coronary Syndrome

Background: The Neutrophil-To-Lymphocyte Ratio (Nlr) Is A Simple Marker Of Systemic Inflammation. This StudyAssessed The Relationship Between Admission Nlr And In-Hospital Mortality Among Patients With Acute CoronarySyndrome (Acs). Materials and Methods: This Hospital-Based Prospective Observational Study Included 50 Patients WithAcs Admitted To A Tertiary Care Centre Over 12 Months. Admission Nlr Was Calculated From Absolute Neutrophil AndLymphocyte Counts. Patients Were Followed Until Discharge Or In-Hospital Death. Clinical Characteristics, LaboratoryFindings And In-Hospital Complications Were Compared Between Survivors And Non-Survivors. Receiver OperatingCharacteristic Analysis Was Used To Assess the Discriminatory Ability of Nlr. Results: Of 50 Patients, Eight (16.0%) DiedDuring Hospitalisation. Median Nlr Was Higher Among Non-Survivors than Survivors (8.2 Vs 3.6, P<0.001). Non-Survivors Had Lower Ejection Fraction (33.4 ± 7.8% Vs 45.2 ± 7.7%, P<0.001) and More Killip Class Iii–Iv Presentation(75.0% Vs 11.9%, P<0.001). Patients with Nlr ≥5 had Higher Heart Failure (45.0% Vs 10.0%, P=0.007), Cardiogenic Shock(35.0% Vs 3.3%, P=0.005) And In-Hospital Mortality (35.0% Vs 3.3%, P=0.005). Nlr ≥5 Was Associated with HigherUnadjusted Odds of Mortality (Or 15.62, 95% Ci 1.73–140.70; P=0.005). At A Cut-Off of 5.2, Nlr Showed an Auc of 0.86With 87.5% Sensitivity And 76.2% Specificity. Conclusion: Higher Admission Nlr Was Associated With Increased In-Hospital Mortality And Complications In Acs. It May Serve As A Simple And Inexpensive Supportive Marker For EarlyRisk Assessment.