Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Neutrophil to Lymphocyte Ratio Predicts Left Ventricular Remodeling in Patients with ST Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention

  • Borekci, Abdurrezzak (Department of Cardiology, School of Medicine, Kafkas University) ;
  • Gur, Mustafa (Department of Cardiology, School of Medicine, Kafkas University) ;
  • Turkoglu, Caner (Department of Cardiology, Yenimahalle State Hospital) ;
  • Baykan, Ahmet Oytun (Department of Cardiology, Adana Numune Training and Research Hospital) ;
  • Seker, Taner (Department of Cardiology, Adana Numune Training and Research Hospital) ;
  • Sahin, Durmus Yildiray (Department of Cardiology, Adana Numune Training and Research Hospital) ;
  • Harbalioglu, Hazar (Department of Cardiology, Adana Numune Training and Research Hospital) ;
  • Elbasan, Zafer (Department of Cardiology, Adana Numune Training and Research Hospital) ;
  • Topuz, Mustafa (Department of Cardiology, Adana Numune Training and Research Hospital) ;
  • Cayli, Murat (Department of Cardiology, School of Medicine, Dicle University)
  • Received : 2015.06.15
  • Accepted : 2015.07.27
  • Published : 2016.01.30
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Abstract

Background and Objectives: It has been demonstrated that the neutrophil/lymphocyte ratio (NLR) might be a useful marker to predict cardiovascular risk and events. We aimed to investigate the role of the NLR to predict ventricular remodeling (VR) in patients with anterior ST-elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention. Subjects and Methods: We prospectively included 274 consecutive anterior STEMI patients. Echocardiography was performed during admission and at six months after myocardial infarction. VR was defined as at least 20% increase from baseline in left ventricular end-diastolic volume. Patients were divided into two groups according to their VR status: VR (n=67) and non-VR (n=207). Total and differential leukocyte count, N-terminal pro-brain natriuretic peptide (NT-proBNP) and other biochemical markers were measured at admission and 24 hours later. Results: Compared with the non-VR group, peak creatine kinase MB (CK-MB), NT-proBNP (24 h), neutrophil/lymphocyte ratio, presence of diabetes, no-reflow frequency and wall motion score index were significantly higher in patients with VR (p<0.05 for all). On multivariate logistic regression analysis, NLR (${\beta}=2.000$, 95% confidence interval=1.577-2.537, p<0.001) as well as peak CK-MB, NT-proBNP (24 h), WMSI and diabetes incidence were associated with VR. The cutoff value of the neutrophil/lymphocyte ratio obtained by receiver operator characteristic curve analysis was 4.25 for the prediction of VR (sensitivity: 79 %, specificity: 74%). Conclusion: In patients with anterior STEMI, initial NLR and NT-proBNP measured 24 hours after admission may be useful for predicting adverse cardiovascular events including left VR.

Keywords

References

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