Usefulness of the Neutrophil to Lymphocyte Ratio in Predicting Long-Term Mortality in ST Segment Elevation Myocardial Infarction

Neutrophil to lymphocyte ratio (N/L) has been associated with poor outcomes in patients who underwent cardiac angiography. Nevertheless, its role for risk stratification in acute coronary syndromes, specifically in patients with ST-segment elevation myocardial infarction (STEMI), has not been elucid...

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Bibliographic Details
Published in:The American journal of cardiology 2008-03, Vol.101 (6), p.747-752
Main Authors: Núñez, Julio, MD, Núñez, Eduardo, MD, MPH, Bodí, Vicent, MD, Sanchis, Juan, MD, Miñana, Gema, MD, Mainar, Luis, MD, Santas, Enrique, MD, Merlos, Pilar, MD, Rumiz, Eva, MD, Darmofal, Helene, Heatta, Anne M, Llàcer, Angel, MD
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Cardiology
Cardiology. Vascular system
Cardiovascular
Cause of Death - trends
Confidence Intervals
Coronary Angiography
Coronary heart disease
Electrocardiography
Female
Follow-Up Studies
Heart
Heart attacks
Humans
Leukocyte Count
Lymphocytes - pathology
Male
Medical imaging
Medical sciences
Middle Aged
Mortality
Myocardial Infarction - blood
Myocardial Infarction - diagnosis
Myocardial Infarction - mortality
Myocarditis. Cardiomyopathies
Neutrophils - pathology
Prognosis
Proportional Hazards Models
Regression analysis
Retrospective Studies
Risk factors
Survival Rate - trends
Time Factors
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Summary:Neutrophil to lymphocyte ratio (N/L) has been associated with poor outcomes in patients who underwent cardiac angiography. Nevertheless, its role for risk stratification in acute coronary syndromes, specifically in patients with ST-segment elevation myocardial infarction (STEMI), has not been elucidated. We sought to determine the association of N/L maximum value (N/Lmax ) with mortality in the setting of STEMI and to compare its predictive ability with total white blood cell maximum count (WBCmax ). We analyzed 515 consecutive patients admitted with STEMI to a single university center. White blood cells (WBC) and differential count were measured at admission and daily for the first 96 hours afterward. Patients with cancer, inflammatory diseases, or premature death were excluded, and 470 patients were included in the final analysis. The association between N/Lmax and WBCmax with mortality was assessed by Cox regression analysis. During follow-up, we registered 106 deaths (22.6%). A positive trend between mortality and N/Lmax quintiles was observed; 6.4%, 12.4%, 11.7%, 34%, and 47.9% of deaths occurred from quintiles 1 to 5 (p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2007.11.004