Neutrophil to Lymphocyte Ratio Predicts Left Ventricular Remodeling in Patients with ST Elevation Myocardial Infarction treated with Primary Percutaneous Intervention

• Published in: Korean circulation journal pp. 15 - 22
• Main Authors: Abdurrezzak Börekçi, Mustafa Gür, Caner Türkoğlu, Ahmet Oytun Baykan, Taner Şeker, Durmuş Yıldıray Şahin, Hazar Harbalıoğlu, Zafer Elbasan, Mustafa Topuz, Murat Çaylı
• Format: Journal Article
• Language: English
• Published: 대한심장학회 01.01.2016
• Subjects: 내과학
• ISSN: 1738-5520; 1738-5555
• DOI: 10.4070/kcj.2016.46.1.15

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 (β=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. KCI Citation Count: 7