Correlation of Neutrophil to Lymphocyte Ratio with in Hospital Mortality in Patients of Acute Coronary Syndrome

• Published in: Pakistan Armed Forces medical journal Vol. 74; no. SUPPL-1; pp. S6 - S11
• Main Authors: Khan, Ismail Ahmed, Shahzad, Syed Khurram, Chaudhry, Azhar Ali, Khan, Sheharbano Ahmed, Aziz, Zohair, Kiani, Sadaf Shabbir, Toru, Fahad Khan
• Format: Journal Article
• Language: English
• Published: Rawalpindi Knowledge Bylanes 30.06.2024; AsiaNet Pakistan (Pvt) Ltd
• Subjects: Acute coronary syndromes; Cardiac patients; Coronary heart disease; Lifesaving; Lymphocytes; Mortality; Neutrophils; Patient outcomes; Risk factors; Tirofiban
• ISSN: 0030-9648; 2411-8842
• DOI: 10.51253/pafmj.v74iSUPPL-1.10495

Objective: To study the correlation of Neutrophil to Lymphocyte Ratio (NLR) with in-hospital mortality in patients of Acute Coronary Syndrome (ACS). Study Design: Analytical Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi, Pakistan, from Jul-Dec 2022. Methodology: One hundred and sixty patients regardless of gender and presented with ACS were included in this study. Their venous blood samples were taken, at the time of admission and were analyzed by the CBC analyzer (Mandray BC 6200) at pathology laboratory and who were delineated into high NLR (>5.25) and low NLR (≤5.25) groups. Their in-hospital morbidity and mortality outcomes were noted. Chi-squared test was applied to compare qualitative variables. Independent samples t-test was applied to compare mean values. Receiver Operating Characteristic (ROC) curve of NLR for predicting in-hospital mortality was plotted, and p-value of <0.05 was considered as statistically significant. Results: Out of n=160 patients, 88(55.0%) were in low NLR group, while 72(45.0%) were in high NLR group. In-hospital mortality was statistically higher in the high NLR group 17(23.6%) vs low NLR group, 3(3.4%), p<0.001). The area under the ROC curve of NLR for predicting in-hospital mortality was 0.75(0.64-0.84). The best cut-off value of NLR to predict in-hospital mortality was 6.70(72.9% sensitivity, 70% specificity) Conclusion: Patients in high NLR group have statistically higher in-hospital mortality. NLR is a sensitive and specific predictor of in-hospital mortality. Patients in the high NLR group also had lower mean EF, and higher mean troponin levels.