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Neutrophil to lymphocyte ratio on admission: Is a predictor of cardiovascular outcome in patients with acute coronary syndrome as it predicts mortality ?

Year 2014, Volume: 17 Issue: 3, 153 - 158, 01.03.2013

Murat Eren Ebru Özpelit Fatih Aytemiz Hasan Güngör Sema Güneri

Abstract

Introduction: It has been recently shown that inflammation may play a role in acute coronary syndrome (ACS). The risk classification of the patients with ACS is inadequite, it requires improving with new and practical parameters. The aim of this study was to invastigate the utility of admission neutrophil / lymphocyte ratio (NLR) in predicting the likelihood of poor outcomes in patients with ACS. Patients and Methods: 209 consecutive patients (mean age: 63.0+10.7, 152 men) admitted to our department with the diagnosis of ACS were included in this study. Patients were divided into three, low (4.7) according to the NLR. The admitting findings, laboratory values, GRACE and TIMI risk scores was recorded and in-hospital mortality, and the total mortality/hospitalisation due to cardiovasculary complications after discharge evaluated in three NLR groups. Results: Significant positive correlation was found between NLR and CRP (p=0.001, r=0.238) troponin I (p

Keywords

Acute coronary syndrome cardiovascular outcome mortality neutrophil to lymphocyte ratio

References

  • Mallika V, Goswami B, Rajappa M. Atherosclerosis pathophysiology and the role of novel risk factors:a clinicobiochemical perspective. Angiology 2007;58:513-22.
  • Falk E, Shah PK, Fuster V. Coronary plaque disruption.Circulation 1995;92:657-71.
  • Libby P. Molecular bases of the acute coronary syndromes.Circulation 1995;91:2844-50.
  • Gurm HS, Bhatt DL, Lincoff AM, Tcheng JE, Kereiakes DJ, Kleiman NS, et al. Impact of preprocedural white blood cell count on long term mortality after percutaneous coronary intervention: insights from the EPIC, EPILOG, and EPISTENT trials. Heart 2003;89:1200-4.
  • Gurm HS, Bhatt DL, Gupta R, Ellis SG, Topol EJ, Lauer MS. Preprocedural white blood cell count and death after percutaneous coronary intervention. Am Heart J 2003;146:692-8.
  • Gillum RF, Mussolino ME, Madans JH. Counts of neutrophils, lymphocytes, and monocytes, cause-specific mortality and coronary heart disease: the NHANES-I epidemiologic follow-up study. Ann Epidemiol 2005;15:266-71.
  • Margolis KL, Manson JE, Greenland P, Rodabough RJ, Bray PF, Safford M, et al. for the Women’s Health Initiative Research G. Leukocyte count as a predictor of cardiovascular events and mortality in postmenopausal women: the Women’s Health Initiative Observational Study. Arch Intern Med 2005;165:500-8.
  • Tsai JC, Sheu SH, Chiu HC, Chung FM, Chang DM, Chen MP, et al. Association of peripheral total and differential leukocyte counts with metabolic syndrome and risk of ischemic cardiovascular diseases in patients with type 2 diabetes mellitus. Diabetes Metab Res Rev 2007;23:111-8.
  • Horne BD, Anderson JL, John JM, Weaver A, Bair TL, Jensen KR, et al. Intermountain Heart Collaborative Study Group. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol 2005;45:1638-43.
  • Mehta J, Dinerman J, Mehta P, Saldeen TG, Lawson D, Donnelly WH, et al. Neutrophil function in ischemic heart disease. Circulation 1989;79:549-56.
  • Barron HV, Cannon CP, Murphy SA, Braunwald E, Gibson CM. Association between white blood cell count, epicardial blood flow, myocardial perfusion, and clinical outcomes in the setting of acute myocardial infarction thrombolysis in myocardial infarction 10 sub study. Circulation 2000;102:2329-34.
  • Pelizzon GG, Dixon SR, Stone GW, Cox DA, Mattos L, Boura JA, et al. Relation of admission white blood cell count to long-term outcomes after primary coronary angioplasty for acute myocardial infarction. Am J Cardiol 2003;91:729-31.
  • Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 2008;102:653-7.
  • Naruko T, Ueda M, Haze K, van der Wal AC, van der Loos CM, Itoh A, et al. Neutrophil infltration of culprit lesions in acute coronary syndromes. Circulation 2002;106:2894-900.
  • Hamm CW, Ravkilde J, Gerhardt W, Jİrgensen P, Peheim E, Ljungdahl L, et al. The prognostic value of serum troponin T in unstable angina. N Engl J Med 1992;327:146-50.
  • Antman EM, Tanasijevic MJ, Thompson B, Schactman M, McCabe CH, Cannon CP, et al. Cardiac specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes. N Engl J Med 1996;335:1342-9.
  • Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ. Neutrophil- lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol 2005;91:181-4.
  • Duffy BK, Gurm HS, Rajagopal V, Gupta R, Ellis SG, Bhatt DL. Usefulness of an elevated neutrophil to lymphocyte ratio in predicting long-term mortality after percutaneous coronary intervention. Am J Cardiol 2006;97:993-6.
  • Kirtane AJ, Bui A, Murphy SA, Barron HV, Gibson CM. Association of peripheral neutrophilia with adverse angiographic outcomes in ST-elevation myocardial infarction. Am J Cardiol 2004;93:532-6.
  • Avanzas P, Quiles J, Lopez de Sa E, Sanchez A, Rubio R, Garcia E, et al. Neutrophil count and infarct size in patients with acute myocardial infarction. Int J Cardiol 2004;97:155-6.
  • Fiarresga AJ, Ferreira RC, Feliciano J, Timoteo AT, Pelicano N, de Sousa L, et al. Prognostic value of neutrophil response in the era of acute myocardial infarction mechanical reperfusion. Rev Port Cardiol 2004;23:1387-96.
  • Ommen SR, Gibbons RJ, Hodge DO, Thomson SP. Usefulness of the lymphocyte concentration as a prognostic marker in coronary artery disease. Am J Cardiol 1997;79:812-4.
  • Gibson PH, Croal BL, Cuthbertson BH, Small GR, Ifezulike AI, Gibson G, et al. Preoperative neutrophil-lymphocyte ratio and outcome from coronary artery bypass grafting. Am Heart J 2007;154:995-1002.
  • Nşñez J, Nşñez E, Bodí V, Sanchis J, Miñana G, Mainar L, et al. Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction. Am J Cardiol 2008;101:747-52.
  • Azab B, Zaher M, Weiserbs KF, Torbey E, Lacossiere K, Gaddam S, et al. Usefulness of neutrophil to lymphocyte ratio in predicting short- and long- term mortality after non-ST-elevation myocardial infarction. Am J Cardiol 2010;106:470-6.
  • Muhammed Suliman MA, Bahnacy Juma AA, Ali Almadhani AA, Pathare AV, Alkindi S, Uwe Werner F. Predictive value of neutrophil to lymphocyte ratio in outcomes ofpatients with acute coronary syndrome. Arch Med Res 2010;41:618-22.
  • Huang G, Zhong XN, Zhong B, Chen YQ, Liu ZZ, Su L, et al. Significance of white blood cell count and its subtypes in patients with acute coronary syndrome. Eur J Clin Invest 2009;39:348-58.
  • Karabinos I, Koulouris S, Kranidis A, Pastromas S, Exadaktylos N, Kalofoutis A. Neutrophil count on admission predicts major in-hospital events in patients with a non-ST-segment elevation acute coronary syndrome. Clin Cardiol 2009;32:561-8.

Başvuru sırasındaki nötrofil/lenfosit oranı: Akut koroner sendromlu hastalarda mortalitenin olduğu gibi kardiyovasküler sonuçların da bir öngördürücüsü müdür ?

Year 2014, Volume: 17 Issue: 3, 153 - 158, 01.03.2013

Murat Eren Ebru Özpelit Fatih Aytemiz Hasan Güngör Sema Güneri

Abstract

Giriş: İnflamasyonun miyokardiyal iskemide önemli bir rol oynadığı gösterilmiştir. Bu hastaların risk sınıflaması açık noktalar içermektedir ve gösterilmiş bu yüksek risk özellikleri yeni ve daha pratik parametreler ile geliştirilmeye ihtiyaç göstermektedir. Bu çalışmada akut koroner sendrom (AKS) tanılı hastalarda başvuru sırasında değerlendirilen nötrofil /lenfosit oranın (NLR) kötü kardiyovasküler sonuçları ve mortaliteyi öngördürücü özelliği değerlendirilmeye çalışılmıştır.Hastalar ve Yöntem: Merkezimizde AKS tanısı (anstabil anjina pektoris / ST-segment yükselmesi olmayan AKS / ST segment yükselmeli AKS ) ile tedavi görmüş 209 hasta çalışmaya dahil edildi. Hastalar NLR'ye göre düşük ( 4,7 ) olmak üzere 3 grup altında değerlendirildi. Hastaların başvuru bulguları, laboratuvar değerleri, GRACE ve TIMI risk skorları kaydedildi ve hastane içi mortalite, 6. ay ve taburculuk sonrası mortalite ve kardiyak nedenli hastane yatış NLR grupları arasında karşılaştırıldı. Bulgular: NLR ile CRP ( p=0,001 r=0,238 ) troponin I (p=

Keywords

Akut koroner sendrom kardiyovasküler sonuçlar mortalite nötrofil lenfosit oranı

References

  • Mallika V, Goswami B, Rajappa M. Atherosclerosis pathophysiology and the role of novel risk factors:a clinicobiochemical perspective. Angiology 2007;58:513-22.
  • Falk E, Shah PK, Fuster V. Coronary plaque disruption.Circulation 1995;92:657-71.
  • Libby P. Molecular bases of the acute coronary syndromes.Circulation 1995;91:2844-50.
  • Gurm HS, Bhatt DL, Lincoff AM, Tcheng JE, Kereiakes DJ, Kleiman NS, et al. Impact of preprocedural white blood cell count on long term mortality after percutaneous coronary intervention: insights from the EPIC, EPILOG, and EPISTENT trials. Heart 2003;89:1200-4.
  • Gurm HS, Bhatt DL, Gupta R, Ellis SG, Topol EJ, Lauer MS. Preprocedural white blood cell count and death after percutaneous coronary intervention. Am Heart J 2003;146:692-8.
  • Gillum RF, Mussolino ME, Madans JH. Counts of neutrophils, lymphocytes, and monocytes, cause-specific mortality and coronary heart disease: the NHANES-I epidemiologic follow-up study. Ann Epidemiol 2005;15:266-71.
  • Margolis KL, Manson JE, Greenland P, Rodabough RJ, Bray PF, Safford M, et al. for the Women’s Health Initiative Research G. Leukocyte count as a predictor of cardiovascular events and mortality in postmenopausal women: the Women’s Health Initiative Observational Study. Arch Intern Med 2005;165:500-8.
  • Tsai JC, Sheu SH, Chiu HC, Chung FM, Chang DM, Chen MP, et al. Association of peripheral total and differential leukocyte counts with metabolic syndrome and risk of ischemic cardiovascular diseases in patients with type 2 diabetes mellitus. Diabetes Metab Res Rev 2007;23:111-8.
  • Horne BD, Anderson JL, John JM, Weaver A, Bair TL, Jensen KR, et al. Intermountain Heart Collaborative Study Group. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol 2005;45:1638-43.
  • Mehta J, Dinerman J, Mehta P, Saldeen TG, Lawson D, Donnelly WH, et al. Neutrophil function in ischemic heart disease. Circulation 1989;79:549-56.
  • Barron HV, Cannon CP, Murphy SA, Braunwald E, Gibson CM. Association between white blood cell count, epicardial blood flow, myocardial perfusion, and clinical outcomes in the setting of acute myocardial infarction thrombolysis in myocardial infarction 10 sub study. Circulation 2000;102:2329-34.
  • Pelizzon GG, Dixon SR, Stone GW, Cox DA, Mattos L, Boura JA, et al. Relation of admission white blood cell count to long-term outcomes after primary coronary angioplasty for acute myocardial infarction. Am J Cardiol 2003;91:729-31.
  • Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 2008;102:653-7.
  • Naruko T, Ueda M, Haze K, van der Wal AC, van der Loos CM, Itoh A, et al. Neutrophil infltration of culprit lesions in acute coronary syndromes. Circulation 2002;106:2894-900.
  • Hamm CW, Ravkilde J, Gerhardt W, Jİrgensen P, Peheim E, Ljungdahl L, et al. The prognostic value of serum troponin T in unstable angina. N Engl J Med 1992;327:146-50.
  • Antman EM, Tanasijevic MJ, Thompson B, Schactman M, McCabe CH, Cannon CP, et al. Cardiac specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes. N Engl J Med 1996;335:1342-9.
  • Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ. Neutrophil- lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol 2005;91:181-4.
  • Duffy BK, Gurm HS, Rajagopal V, Gupta R, Ellis SG, Bhatt DL. Usefulness of an elevated neutrophil to lymphocyte ratio in predicting long-term mortality after percutaneous coronary intervention. Am J Cardiol 2006;97:993-6.
  • Kirtane AJ, Bui A, Murphy SA, Barron HV, Gibson CM. Association of peripheral neutrophilia with adverse angiographic outcomes in ST-elevation myocardial infarction. Am J Cardiol 2004;93:532-6.
  • Avanzas P, Quiles J, Lopez de Sa E, Sanchez A, Rubio R, Garcia E, et al. Neutrophil count and infarct size in patients with acute myocardial infarction. Int J Cardiol 2004;97:155-6.
  • Fiarresga AJ, Ferreira RC, Feliciano J, Timoteo AT, Pelicano N, de Sousa L, et al. Prognostic value of neutrophil response in the era of acute myocardial infarction mechanical reperfusion. Rev Port Cardiol 2004;23:1387-96.
  • Ommen SR, Gibbons RJ, Hodge DO, Thomson SP. Usefulness of the lymphocyte concentration as a prognostic marker in coronary artery disease. Am J Cardiol 1997;79:812-4.
  • Gibson PH, Croal BL, Cuthbertson BH, Small GR, Ifezulike AI, Gibson G, et al. Preoperative neutrophil-lymphocyte ratio and outcome from coronary artery bypass grafting. Am Heart J 2007;154:995-1002.
  • Nşñez J, Nşñez E, Bodí V, Sanchis J, Miñana G, Mainar L, et al. Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction. Am J Cardiol 2008;101:747-52.
  • Azab B, Zaher M, Weiserbs KF, Torbey E, Lacossiere K, Gaddam S, et al. Usefulness of neutrophil to lymphocyte ratio in predicting short- and long- term mortality after non-ST-elevation myocardial infarction. Am J Cardiol 2010;106:470-6.
  • Muhammed Suliman MA, Bahnacy Juma AA, Ali Almadhani AA, Pathare AV, Alkindi S, Uwe Werner F. Predictive value of neutrophil to lymphocyte ratio in outcomes ofpatients with acute coronary syndrome. Arch Med Res 2010;41:618-22.
  • Huang G, Zhong XN, Zhong B, Chen YQ, Liu ZZ, Su L, et al. Significance of white blood cell count and its subtypes in patients with acute coronary syndrome. Eur J Clin Invest 2009;39:348-58.
  • Karabinos I, Koulouris S, Kranidis A, Pastromas S, Exadaktylos N, Kalofoutis A. Neutrophil count on admission predicts major in-hospital events in patients with a non-ST-segment elevation acute coronary syndrome. Clin Cardiol 2009;32:561-8.
There are 28 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Murat Eren This is me

Ebru Özpelit This is me

Fatih Aytemiz This is me

Hasan Güngör This is me

Sema Güneri This is me

Publication Date March 1, 2013
Published in Issue Year 2014 Volume: 17 Issue: 3

Cite

APA Eren, M. ., Özpelit, E. ., Aytemiz, F. ., Güngör, H. ., et al. (2013). Başvuru sırasındaki nötrofil/lenfosit oranı: Akut koroner sendromlu hastalarda mortalitenin olduğu gibi kardiyovasküler sonuçların da bir öngördürücüsü müdür ?. Koşuyolu Kalp Dergisi, 17(3), 153-158.
AMA Eren M, Özpelit E, Aytemiz F, Güngör H, Güneri S. Başvuru sırasındaki nötrofil/lenfosit oranı: Akut koroner sendromlu hastalarda mortalitenin olduğu gibi kardiyovasküler sonuçların da bir öngördürücüsü müdür ?. Koşuyolu Kalp Dergisi. March 2013;17(3):153-158.
Chicago Eren, Murat, Ebru Özpelit, Fatih Aytemiz, Hasan Güngör, and Sema Güneri. “Başvuru sırasındaki nötrofil/Lenfosit oranı: Akut Koroner Sendromlu Hastalarda Mortalitenin olduğu Gibi kardiyovasküler sonuçların Da Bir öngördürücüsü müdür ?”. Koşuyolu Kalp Dergisi 17, no. 3 (March 2013): 153-58.
EndNote Eren M, Özpelit E, Aytemiz F, Güngör H, Güneri S (March 1, 2013) Başvuru sırasındaki nötrofil/lenfosit oranı: Akut koroner sendromlu hastalarda mortalitenin olduğu gibi kardiyovasküler sonuçların da bir öngördürücüsü müdür ?. Koşuyolu Kalp Dergisi 17 3 153–158.
IEEE M. . Eren, E. . Özpelit, F. . Aytemiz, H. . Güngör, and S. . Güneri, “Başvuru sırasındaki nötrofil/lenfosit oranı: Akut koroner sendromlu hastalarda mortalitenin olduğu gibi kardiyovasküler sonuçların da bir öngördürücüsü müdür ?”, Koşuyolu Kalp Dergisi, vol. 17, no. 3, pp. 153–158, 2013.
ISNAD Eren, Murat et al. “Başvuru sırasındaki nötrofil/Lenfosit oranı: Akut Koroner Sendromlu Hastalarda Mortalitenin olduğu Gibi kardiyovasküler sonuçların Da Bir öngördürücüsü müdür ?”. Koşuyolu Kalp Dergisi 17/3 (March 2013), 153-158.
JAMA Eren M, Özpelit E, Aytemiz F, Güngör H, Güneri S. Başvuru sırasındaki nötrofil/lenfosit oranı: Akut koroner sendromlu hastalarda mortalitenin olduğu gibi kardiyovasküler sonuçların da bir öngördürücüsü müdür ?. Koşuyolu Kalp Dergisi. 2013;17:153–158.
MLA Eren, Murat et al. “Başvuru sırasındaki nötrofil/Lenfosit oranı: Akut Koroner Sendromlu Hastalarda Mortalitenin olduğu Gibi kardiyovasküler sonuçların Da Bir öngördürücüsü müdür ?”. Koşuyolu Kalp Dergisi, vol. 17, no. 3, 2013, pp. 153-8.
Vancouver Eren M, Özpelit E, Aytemiz F, Güngör H, Güneri S. Başvuru sırasındaki nötrofil/lenfosit oranı: Akut koroner sendromlu hastalarda mortalitenin olduğu gibi kardiyovasküler sonuçların da bir öngördürücüsü müdür ?. Koşuyolu Kalp Dergisi. 2013;17(3):153-8.