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Neutrophil to lymphocyte ratio in relation to risk of all-cause mortality and cardiovascular events among patients undergoing angiography or cardiac revascularization: A meta-analysis of observational studies

Abstract Objective The aim of this study was to investigate whether neutrophil to lymphocyte ratio (NLR) was an independent predictor for all-cause mortality or cardiovascular events in patients undergoing angiography or cardiac revascularization with observational studies by meta-analysis. Methods...

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Published in:Atherosclerosis 2014-05, Vol.234 (1), p.206-213
Main Authors: Wang, Xiaoding, Zhang, Guangyu, Jiang, Xuejun, Zhu, Hongling, Lu, Zhao, Xu, Lin
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Language:English
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cited_by cdi_FETCH-LOGICAL-c510t-cdfe577008d225ed85561d0f2a5c64b890d92a633d9c86eda666adb07f2450433
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container_end_page 213
container_issue 1
container_start_page 206
container_title Atherosclerosis
container_volume 234
creator Wang, Xiaoding
Zhang, Guangyu
Jiang, Xuejun
Zhu, Hongling
Lu, Zhao
Xu, Lin
description Abstract Objective The aim of this study was to investigate whether neutrophil to lymphocyte ratio (NLR) was an independent predictor for all-cause mortality or cardiovascular events in patients undergoing angiography or cardiac revascularization with observational studies by meta-analysis. Methods Pubmed and Embase were searched without language restrictions for cohort studies published prior to November 2013. Citations were independently screened by 2 authors, and those meeting the inclusion criteria defined a priori were retained. Data on authors, year of publication, location, target participant, comparison of NLR, outcome assessment, number of event and sample size, duration and statistical adjustments were abstracted. Results Eight studies were identified that reported on all-cause mortality and five studies were identified that reported on cardiovascular events. The pooled relative risk (RR) of all-cause mortality was 2.33 (95% CI 1.88–2.88) and the RR of cardiovascular events was 1.89 (95% CI 1.42, 2.52) comparing the highest with the lowest category of NLR. Conclusions The meta-analysis indicates that NLR is a predictor of all-cause mortality and cardiovascular events. Further well-designed trials are warranted to confirm this association.
doi_str_mv 10.1016/j.atherosclerosis.2014.03.003
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Methods Pubmed and Embase were searched without language restrictions for cohort studies published prior to November 2013. Citations were independently screened by 2 authors, and those meeting the inclusion criteria defined a priori were retained. Data on authors, year of publication, location, target participant, comparison of NLR, outcome assessment, number of event and sample size, duration and statistical adjustments were abstracted. Results Eight studies were identified that reported on all-cause mortality and five studies were identified that reported on cardiovascular events. The pooled relative risk (RR) of all-cause mortality was 2.33 (95% CI 1.88–2.88) and the RR of cardiovascular events was 1.89 (95% CI 1.42, 2.52) comparing the highest with the lowest category of NLR. Conclusions The meta-analysis indicates that NLR is a predictor of all-cause mortality and cardiovascular events. Further well-designed trials are warranted to confirm this association.</description><identifier>ISSN: 0021-9150</identifier><identifier>EISSN: 1879-1484</identifier><identifier>DOI: 10.1016/j.atherosclerosis.2014.03.003</identifier><identifier>PMID: 24681815</identifier><language>eng</language><publisher>Ireland: Elsevier Ireland Ltd</publisher><subject>All-cause mortality ; Cardiovascular ; Cardiovascular Diseases - blood ; Cardiovascular Diseases - epidemiology ; Cardiovascular events ; Cause of Death ; Coronary Angiography ; Coronary Artery Disease - blood ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - mortality ; Coronary Artery Disease - surgery ; Humans ; Leukocyte Count ; Lymphocytes ; Meta-analysis ; Myocardial Revascularization ; Neutrophil/lymphocyte ratio ; Neutrophils ; Observational Studies as Topic ; Risk Assessment</subject><ispartof>Atherosclerosis, 2014-05, Vol.234 (1), p.206-213</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2014 Elsevier Ireland Ltd</rights><rights>Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c510t-cdfe577008d225ed85561d0f2a5c64b890d92a633d9c86eda666adb07f2450433</citedby><cites>FETCH-LOGICAL-c510t-cdfe577008d225ed85561d0f2a5c64b890d92a633d9c86eda666adb07f2450433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24681815$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Xiaoding</creatorcontrib><creatorcontrib>Zhang, Guangyu</creatorcontrib><creatorcontrib>Jiang, Xuejun</creatorcontrib><creatorcontrib>Zhu, Hongling</creatorcontrib><creatorcontrib>Lu, Zhao</creatorcontrib><creatorcontrib>Xu, Lin</creatorcontrib><title>Neutrophil to lymphocyte ratio in relation to risk of all-cause mortality and cardiovascular events among patients undergoing angiography or cardiac revascularization: A meta-analysis of observational studies</title><title>Atherosclerosis</title><addtitle>Atherosclerosis</addtitle><description>Abstract Objective The aim of this study was to investigate whether neutrophil to lymphocyte ratio (NLR) was an independent predictor for all-cause mortality or cardiovascular events in patients undergoing angiography or cardiac revascularization with observational studies by meta-analysis. Methods Pubmed and Embase were searched without language restrictions for cohort studies published prior to November 2013. Citations were independently screened by 2 authors, and those meeting the inclusion criteria defined a priori were retained. Data on authors, year of publication, location, target participant, comparison of NLR, outcome assessment, number of event and sample size, duration and statistical adjustments were abstracted. Results Eight studies were identified that reported on all-cause mortality and five studies were identified that reported on cardiovascular events. The pooled relative risk (RR) of all-cause mortality was 2.33 (95% CI 1.88–2.88) and the RR of cardiovascular events was 1.89 (95% CI 1.42, 2.52) comparing the highest with the lowest category of NLR. Conclusions The meta-analysis indicates that NLR is a predictor of all-cause mortality and cardiovascular events. Further well-designed trials are warranted to confirm this association.</description><subject>All-cause mortality</subject><subject>Cardiovascular</subject><subject>Cardiovascular Diseases - blood</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular events</subject><subject>Cause of Death</subject><subject>Coronary Angiography</subject><subject>Coronary Artery Disease - blood</subject><subject>Coronary Artery Disease - diagnostic imaging</subject><subject>Coronary Artery Disease - mortality</subject><subject>Coronary Artery Disease - surgery</subject><subject>Humans</subject><subject>Leukocyte Count</subject><subject>Lymphocytes</subject><subject>Meta-analysis</subject><subject>Myocardial Revascularization</subject><subject>Neutrophil/lymphocyte ratio</subject><subject>Neutrophils</subject><subject>Observational Studies as Topic</subject><subject>Risk Assessment</subject><issn>0021-9150</issn><issn>1879-1484</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNqNUk1v1DAQjRCIlsJfQL4gcckydj4XCaSqKgWpggNwtmbtya63ThxsZ6XwK_lJOLsth544-PvNe555k2VvOKw48PrdfoVxR94FZZfZhJUAXq6gWAEUT7Jz3jbrnJdt-TQ7BxA8X_MKzrIXIewBoGx4-zw7E2Xd8pZX59mfrzRF78adsSw6Zud-3Dk1R2Ieo3HMDMyTXbbD8u5NuGOuY2htrnAKxHrnI1oTZ4aDZgq9Nu6AQU0WPaMDDTEw7N2wZWNiOR6nQZPfOpPucNgat_U47mbm_CkcVZJ8oDC_j9rv2SXrKWKOA9o5Zb18wm0C-cPxHS0LcdKGwsvsWYc20Kv79SL7-en6x9Xn_PbbzZery9tcVRxirnRHVdMAtFqIinRbVTXX0AmsVF1u2jXotcC6KPRatTVprOsa9QaaTpQVlEVxkb098Y7e_ZooRNmboMhaHMhNQfJK1Fw0XIgE_XCCqmRY8NTJ0Zse_Sw5yMVUuZePTJWLqRIKmUxN8a_vpaZNT_pf9IOLCXBzAlBK-GDIy6BSqRVp40lFqZ35b6mPj5iUNYNRaO9oprB3k0-1TtnJICTI70uHLQ3GS0ijbYu_-z_ZDw</recordid><startdate>20140501</startdate><enddate>20140501</enddate><creator>Wang, Xiaoding</creator><creator>Zhang, Guangyu</creator><creator>Jiang, Xuejun</creator><creator>Zhu, Hongling</creator><creator>Lu, Zhao</creator><creator>Xu, Lin</creator><general>Elsevier Ireland Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140501</creationdate><title>Neutrophil to lymphocyte ratio in relation to risk of all-cause mortality and cardiovascular events among patients undergoing angiography or cardiac revascularization: A meta-analysis of observational studies</title><author>Wang, Xiaoding ; Zhang, Guangyu ; Jiang, Xuejun ; Zhu, Hongling ; Lu, Zhao ; Xu, Lin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c510t-cdfe577008d225ed85561d0f2a5c64b890d92a633d9c86eda666adb07f2450433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>All-cause mortality</topic><topic>Cardiovascular</topic><topic>Cardiovascular Diseases - blood</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular events</topic><topic>Cause of Death</topic><topic>Coronary Angiography</topic><topic>Coronary Artery Disease - blood</topic><topic>Coronary Artery Disease - diagnostic imaging</topic><topic>Coronary Artery Disease - mortality</topic><topic>Coronary Artery Disease - surgery</topic><topic>Humans</topic><topic>Leukocyte Count</topic><topic>Lymphocytes</topic><topic>Meta-analysis</topic><topic>Myocardial Revascularization</topic><topic>Neutrophil/lymphocyte ratio</topic><topic>Neutrophils</topic><topic>Observational Studies as Topic</topic><topic>Risk Assessment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Xiaoding</creatorcontrib><creatorcontrib>Zhang, Guangyu</creatorcontrib><creatorcontrib>Jiang, Xuejun</creatorcontrib><creatorcontrib>Zhu, Hongling</creatorcontrib><creatorcontrib>Lu, Zhao</creatorcontrib><creatorcontrib>Xu, Lin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Atherosclerosis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Xiaoding</au><au>Zhang, Guangyu</au><au>Jiang, Xuejun</au><au>Zhu, Hongling</au><au>Lu, Zhao</au><au>Xu, Lin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neutrophil to lymphocyte ratio in relation to risk of all-cause mortality and cardiovascular events among patients undergoing angiography or cardiac revascularization: A meta-analysis of observational studies</atitle><jtitle>Atherosclerosis</jtitle><addtitle>Atherosclerosis</addtitle><date>2014-05-01</date><risdate>2014</risdate><volume>234</volume><issue>1</issue><spage>206</spage><epage>213</epage><pages>206-213</pages><issn>0021-9150</issn><eissn>1879-1484</eissn><abstract>Abstract Objective The aim of this study was to investigate whether neutrophil to lymphocyte ratio (NLR) was an independent predictor for all-cause mortality or cardiovascular events in patients undergoing angiography or cardiac revascularization with observational studies by meta-analysis. Methods Pubmed and Embase were searched without language restrictions for cohort studies published prior to November 2013. Citations were independently screened by 2 authors, and those meeting the inclusion criteria defined a priori were retained. Data on authors, year of publication, location, target participant, comparison of NLR, outcome assessment, number of event and sample size, duration and statistical adjustments were abstracted. Results Eight studies were identified that reported on all-cause mortality and five studies were identified that reported on cardiovascular events. The pooled relative risk (RR) of all-cause mortality was 2.33 (95% CI 1.88–2.88) and the RR of cardiovascular events was 1.89 (95% CI 1.42, 2.52) comparing the highest with the lowest category of NLR. Conclusions The meta-analysis indicates that NLR is a predictor of all-cause mortality and cardiovascular events. Further well-designed trials are warranted to confirm this association.</abstract><cop>Ireland</cop><pub>Elsevier Ireland Ltd</pub><pmid>24681815</pmid><doi>10.1016/j.atherosclerosis.2014.03.003</doi><tpages>8</tpages></addata></record>
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subjects All-cause mortality
Cardiovascular
Cardiovascular Diseases - blood
Cardiovascular Diseases - epidemiology
Cardiovascular events
Cause of Death
Coronary Angiography
Coronary Artery Disease - blood
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - mortality
Coronary Artery Disease - surgery
Humans
Leukocyte Count
Lymphocytes
Meta-analysis
Myocardial Revascularization
Neutrophil/lymphocyte ratio
Neutrophils
Observational Studies as Topic
Risk Assessment
title Neutrophil to lymphocyte ratio in relation to risk of all-cause mortality and cardiovascular events among patients undergoing angiography or cardiac revascularization: A meta-analysis of observational studies
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