The Neutrophil‐to‐Lymphocyte Ratio Predicts All‐Cause Mortality in Patients with Implantable Cardioverter Defibrillators

• Published in: Pacing and clinical electrophysiology 2017-02, Vol.40 (2), p.135-144
• Main Authors: HASHIMOTO, NAOAKI, ARIMOTO, TAKANORI, NARUMI, TARO, IWAYAMA, TADATERU, KUTSUZAWA, DAISUKE, ISHIGAKI, DAISUKE, KUMAGAI, YU, TAMURA, HARUTOSHI, NISHIYAMA, SATOSHI, TAKAHASHI, HIROKI, SHISHIDO, TETSURO, MIYAMOTO, TAKUYA, WATANABE, TETSU, KUBOTA, ISAO
• Format: Article
• Language: English
• Subjects: all‐cause mortality; Brain natriuretic peptide; Cardiomyopathies - mortality; Cardiomyopathies - pathology; Cardiomyopathies - therapy; Cardiomyopathy; Defibrillators; Defibrillators, Implantable - statistics & numerical data; Electric Countershock - mortality; Female; Glomerular filtration rate; Health risk assessment; Humans; implantable cardioverter‐defibrillator; Incidence; Japan - epidemiology; Leukocyte Count - statistics & numerical data; Lymphocytes - pathology; Male; Middle Aged; Mortality; Neutrophils; Neutrophils - pathology; neutrophil‐to‐lymphocyte ratio; Prognosis; Proportional Hazards Models; Reproducibility of Results; Risk Assessment; Sensitivity and Specificity; Survival Analysis; Treatment Outcome
• ISSN: 0147-8389; 1540-8159
• DOI: 10.1111/pace.13003

Background The relationship between the neutrophil‐to‐lymphocyte ratio (NLR) and outcome in patients with implantable cardioverter‐defibrillators (ICDs) is unclear. Methods and Results Consecutive patients with cardiomyopathy who had received an ICD (n = 120, mean age 64 ± 11 years) were prospectively enrolled. Blood samples were obtained on the morning of the day of implantation. Patients were followed for a median period of 61.2 months, to an endpoint of all‐cause mortality or appropriate ICD shock, which occurred in 35 (29%) and 28 (23%) patients, respectively. Multivariate Cox analysis revealed that secondary prevention was only associated with appropriate ICD shocks. The NLR, brain natriuretic peptide level, and estimated glomerular filtration rate were independent predictors of all‐cause mortality but not of appropriate ICD shocks. Subgroup analysis revealed that a high NLR (≥2.1) was valuable for anticipating all‐cause mortality among patients who had received ICDs for primary or secondary prevention. A high NLR was also associated with death prior to appropriate ICD shock. Conclusion Evaluating the NLR may be useful for predicting outcomes in patients with cardiomyopathy who have received ICDs.