Neutrophil-to-lymphocyte ratio and prognosis in patients undergoing percutaneous coronary intervention for acute coronary syndrome

Cardiovasc Revasc Med. 2024 Mar:60:29-34. doi: 10.1016/j.carrev.2023.09.003. Epub 2023 Sep 12.

Abstract

Objective: The purpose of this study was to characterize Acute Coronary Syndrome (ACS)-associated inflammation by investigating correlates of the neutrophil-to-lymphocyte ratio (NLR), a surrogate marker of inflammation, and its relation to 1-year mortality in a cohort of patients undergoing percutaneous coronary intervention (PCI) for ACS at a single institution.

Methods: We performed a single-institution, retrospective, observational study of all-comer ACS patients who underwent PCI and were discharged home before the COVID-19 pandemic between September 23, 2011 and July 31, 2017 for who outcomes data were available.

Results: NLRhigh group tended to be older, white patients, less likely to smoke, more likely to have a history of heart failure and cardiac arrest, higher creatinine values, lower LVEF, and higher CK-MB (a surrogate for infarct size). Linear regression model demonstrated a strong correlation between increasing NLR and white race (B = 1.103, p = 0.001, hemoglobin (B = -0.30, p < 0.001), peak CK-MB (B = 0.004, p = 0.02), LVEF (B = -0.048, p < 0.001), and serum creatinine (B = 0.47, p = 0.03). There were a total of 87 deaths at one year. NLR > 3.4 was associated with worse one-year survival post-PCI (91.4 % vs. 95.4 %, log-rank p < 0.004), which was confirmed on multivariate analysis.

Conclusion: Our data confirm the independent prognostic significance of inflammation to mortality after ACS and may provide some insight into the putative benefits of inflammation modulation.

Keywords: ACS-associated inflammation; Neutrophil-to-lymphocyte ratio.

Publication types

  • Observational Study

MeSH terms

  • Acute Coronary Syndrome* / diagnostic imaging
  • Acute Coronary Syndrome* / therapy
  • Creatine Kinase, MB Form
  • Humans
  • Inflammation
  • Lymphocytes
  • Neutrophils
  • Pandemics
  • Percutaneous Coronary Intervention* / adverse effects
  • Prognosis
  • Retrospective Studies

Substances

  • Creatine Kinase, MB Form