Key result
Higher admission neutrophil-to-lymphocyte ratio is linked to ~89% greater likelihood of pre-PCI infarct artery patency.
Why the study?
Reduced baseline coronary flow in an infarct-related artery before PPCI increases mortality in STEMI patients, and the association of neutrophil/lymphocyte ratio with IRA patency before mechanical reperfusion was unclear.
Does the neutrophil/lymphocyte ratio at admission predict infarct-related artery patency before primary PCI in patients with STEMI?
Observational (n=404)
Does the neutrophil/lymphocyte ratio at admission predict infarct-related artery patency before primary PCI in patients with STEMI?
Odds Ratio: 1.89 (95% CI 1.82–1.98)
p-value: p=0.001
The neutrophil/lymphocyte ratio at admission is a simple, independent predictor of early infarct-related artery patency before primary PCI in STEMI patients.
May aid STEMI risk stratification; leaves open whether neutrophil/lymphocyte ratio should guide pre-PCI decisions.
OBJECTIVES: Reduced baseline coronary flow in an infarct-related artery (IRA) before a primary percutaneous coronary intervention (PPCI) increases mortality in patients with ST-elevation myocardial infarction (STEMI). Increased neutrophil/lymphocyte (N/L) ratio has been linked to poor clinical outcomes in patients with STEMI. We investigated whether the N/L ratio, as measured at admission, was associated with IRA patency before mechanical reperfusion in patients with STEMI undergoing PPCI. PATIENTS AND METHODS: A total of 404 patients who had undergone PPCI on a single culprit artery were enrolled in this study. According to thrombolysis in myocardial infarction (TIMI) flow grade in the IRA before PPCI, the study population was divided into two groups as TIMI 0 or 1 group (occluded IRA) and TIMI 2 or 3 group (patent IRA). RESULTS: The N/L ratios were found to be significantly higher in the TIMI flow 0/1 group when compared with the TIMI flow 2/3 group (6.08±3.94 vs. 4.01±2.87, P=0.001). The absence of early IRA patency was associated with higher Syntax score, mean platelet volume, creatine kinase-myocardial band, and troponin T levels (P=0.0001, P=0.03, P<0.001, and P=0.004, respectively), and lower left ventricular ejection fraction (P=0.02). Multivariate logistic regression analysis showed that the N/L ratio and Syntax score were independent predictors of IRA patency (odds ratio: 1.89, 95% confidence interval: 1.82-1.98; odds ratio=2.80, 95% confidence interval: 1.75-3.86, respectively; P=0.001). CONCLUSION: The N/L ratio has been found to be associated independently with early IRA patency before PPCI in patients who have undergone PCI for STEMI. This simple and cheap parameter can provide useful information on the related risk evaluation in these patients.
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Kurtul et al. (2013) conducted an observational in ST-elevation myocardial infarction (STEMI) (n=404). Neutrophil/lymphocyte (N/L) ratio was evaluated on Infarct-related artery patency before mechanical reperfusion (OR 1.89, 95% CI 1.82-1.98, p=0.001). Higher neutrophil/lymphocyte ratio at admission was independently associated with early infarct-related artery patency before primary PCI in STEMI patients (OR 1.89; 95% CI 1.82-1.98; P=0.001).
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