Key result
Elevated admission neutrophil–lymphocyte ratio independently predicted 30-day major adverse cardiac events in acute MI patients.
Why the study?
The neutrophil-lymphocyte ratio (NLR) is a simple, cost-effective potential prognostic indicator for cardiovascular events, but definitive data regarding its utility in early risk stratification following an acute MI remained limited.
Does an elevated admission neutrophil-lymphocyte ratio predict 30-day major adverse cardiac events in adult patients presenting with acute myocardial infarction?
Cohort (n=120)
No
Does an elevated admission neutrophil-lymphocyte ratio predict 30-day major adverse cardiac events in adult patients presenting with acute myocardial infarction?
Answers are grounded in this paper and cite their sources.
Admission neutrophil–lymphocyte ratio is a simple, cost-effective, independent predictor of 30-day major adverse cardiac events, lower discharge LVEF, and longer hospital stay in patients presenting with acute myocardial infarction.
Background: Myocardial infarction (MI) remains a leading cause of morbidity and mortality worldwide. While various clinical markers and risk scores exist for early prognostication, emerging evidence highlights the importance of inflammatory markers in predicting adverse outcomes. The neutrophil–lymphocyte ratio (NLR), a simple and cost-effective hematological index, has gained increasing attention as a potential prognostic indicator for cardiovascular events. However, definitive data regarding its utility in early risk stratification following an acute MI remain limited. Methods: This prospective observational study included 120 adult patients diagnosed with acute MI (STelevation or non-ST-elevation) and admitted to a tertiary care center. Blood samples were collected on admission to evaluate complete blood counts and calculate the NLR. Relevant clinical data, including demographics, risk factors, and echocardiographic parameters, were recorded. Patients were categorized into quartiles based on their admission NLR. The primary outcome was a composite of major adverse cardiac events (MACE) within 30 days, including mortality, recurrent MI, and acute heart failure. Secondary outcomes included length of hospital stay and left ventricular ejection fraction (LVEF) at discharge. Logistic regression analyses were performed to ascertain the independent prognostic value of NLR. Results: A higher NLR on admission was significantly associated with increased rates of MACE (p < 0.001). Patients in the highest NLR quartile demonstrated a greater incidence of mortality and heart failure compared to those in the lower quartiles. Multivariate regression identified elevated NLR as an independent predictor of early adverse outcomes after adjusting for established risk factors such as age, Killip class, and left ventricular systolic function. Conclusion: These findings suggest that admission NLR is a valuable, non-invasive prognostic biomarker for early risk stratification in patients with acute MI. Incorporating NLR into existing clinical assessment may enhance decision-making and potentially improve outcomes.
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Kanwaria et al. (2026) conducted a cohort in Acute myocardial infarction (STEMI or NSTEMI) (n=120). Admission neutrophil–lymphocyte ratio (NLR) vs. Lower NLR quartiles (Q1–Q3) or per 1-unit lower NLR was evaluated on Composite of major adverse cardiac events (MACE) within 30 days, including mortality, recurrent MI, and acute decompensated heart failure requiring intravenous therapy (OR 2.64, 95% CI 1.45–4.22, p=<0.001). Elevated admission neutrophil–lymphocyte ratio independently predicted 30-day major adverse cardiac events in acute MI patients.
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