Key result
In patients with acute myocardial infarction and LMD/3VD undergoing PCI, an admission NLR ≥ 3.39 independently predicted 2-year all-cause mortality (6.7% vs 0.9%; HR 3.08, 95% CI 1.06-8.97; P=0.039).
Why the study?
The prognostic value of neutrophil to lymphocyte ratio (NLR) in patients with left main and/or three-vessel disease (LMD/3VD) undergoing PCI after acute myocardial infarction is not clearly defined.
Cohort (n=806)
Hazard Ratio: 3.08 (95% CI 1.06–8.97)
Absolute Event Rate: 6.7% vs 0.9%
p-value: p=0.039
OBJECTIVES: We sought to evaluate the independent predictive value of left main disease (LMD) and/or three-vessel disease (LMD/3VD) in acute myocardial infarction (AMI) patients. BACKGROUND: Patients with acute coronary syndrome resulting from LMD and/or three-vessel disease (LMD/3VD) are at the highest risk of adverse cardiovascular events. Neutrophil to lymphocyte ratio (NLR) has been proposed as a marker of cardiovascular risk, but the prognostic value of NLR in patients with LMD/3VD who underwent percutaneous coronary intervention (PCI) is not clearly defined. METHODS: Patients (n = 806) admitted with LMD/3VD who underwent PCI between January 2013 and December 2013 were followed up for 2 years. Admission NLR was divided into two sub-groups based on an optimal cut off value predicting 2-year all-cause mortality. The primary end point was all-cause death. The secondary end point was long-term major adverse cardiovascular and cerebrovascular events (MACCE). RESULTS: During follow-up, the high NLR group was associated with a significantly higher rate of long-term all-cause mortality (6.7 vs. 0.9%, P < .001), and MACCE (24.7 vs. 15.8%, P = .002) compared to the low NLR group. In multivariate analysis, after adjusting for risk factors, NLR ≥ 3.39 was determined to be an independent predictor of 2-year all-cause mortality (hazard ratio[HR] 3.08, 95% confidence interval [CI] 1.06 to 8.97, P = .039) and MACCE (hazard ratio 1.44, 95% CI 1.01 to 2.05, P = .046) for LMD/3VD. CONCLUSIONS: The admission NLR as relatively inexpensive marker of inflammation may aid in the risk stratification and prognosis of patients diagnosed with LMD/3VD.
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Xu et al. (2018) conducted a cohort in Acute myocardial infarction with left main and/or three-vessel disease (n=806). High admission neutrophil to lymphocyte ratio (NLR ≥ 3.39) vs. Low admission neutrophil to lymphocyte ratio (NLR < 3.39) was evaluated on All-cause death (HR 3.08, 95% CI 1.06 to 8.97, p=0.039). In patients with acute myocardial infarction and LMD/3VD undergoing PCI, an admission NLR ≥ 3.39 independently predicted 2-year all-cause mortality (6.7% vs 0.9%; HR 3.08, 95% CI 1.06-8.97; P=0.039).
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