Neutrophil to Lymphocyte Ratio as a Prognostic Predictor in Older People With Acute Coronary Syndrome

Angiology. 2019 Mar;70(3):264-271. doi: 10.1177/0003319718796565. Epub 2018 Aug 28.

Abstract

The neutrophil to lymphocyte ratio (NLR) at admission is a prognostic marker for acute coronary syndrome (ACS). However, no study was performed exclusively with older people. The present study evaluated the NLR in older people with ACS as a predictor of death, combined major in-hospital outcomes (death, stroke, reinfarction), hospital stay, ventricular ejection fraction, use of vasoactive drugs, and extent of coronary artery disease. We conducted a retrospective cohort study with in-hospital follow-up using data from a single center in Recife, Brazil. Patients aged 60 and older admitted with ACS were selected. The patients were followed until discharge or death. A total of 272 individuals were evaluated; 55.8% were men and the mean age was 73 years. The NLR was not a predictor of in-hospital death. A higher NLR upon admission was associated with a longer hospital stay (β = 0.131; 95% confidence interval [CI]: 0.017-0.246; P = .024) and an ejection fraction <50% (relative risk = 2.1; 95% CI: 1.19-3.57; P = .001). The other outcomes did not reach significance. The NLR was associated with a longer hospital stay and a left ventricular ejection fraction <50% in older people with ACS.

Keywords: acute coronary syndrome; lymphocytes; neutrophils; neutrophil–lymphocyte ratio; older.

MeSH terms

  • Acute Coronary Syndrome / diagnosis*
  • Acute Coronary Syndrome / pathology*
  • Adult
  • Aged
  • Female
  • Humans
  • Lymphocytes / pathology*
  • Male
  • Middle Aged
  • Neutrophils / pathology*
  • Percutaneous Coronary Intervention / methods
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Stroke Volume / physiology
  • Ventricular Function, Left / physiology