Neutrophil to lymphocyte ratio predict mortality and major adverse cardiac events in acute coronary syndrome: A systematic review and meta-analysis

Dong, Chaohui; Wang, Zhang-Min; Chen, Siyu

doi:10.1016/j.clinbiochem.2017.11.008

Cited by 159 publications

(99 citation statements)

References 28 publications

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“…6 The neutrophil-to-lymphocyte ratio (NLR) therefore represents the balance between inflammation and immune regulation. It has been shown to predict mortality and major adverse cardiac events in acute coronary syndromes, 7 degenerative aortic stenosis, 8 acute rejection after heart transplantation, 9 and acute myocardial infarction.…”

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confidence: 99%

The neutrophil-to-lymphocyte ratio and mean platelet volume can be associated with severity of valvular involvement in patients with acute rheumatic carditis

Çelik¹,

Çelik²

2018

CVJA

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Objectives: The aim of the study was to investigate the association between the severity of acute rheumatic carditis (ARC) and the neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV). Methods: Paediatric patients diagnosed with ARC between 2010 and 2016 and age-and gender-matched controls were retrospectively analysed. At the time of diagnosis, we reviewed the demographic features obtained: echocardiographic data, complete blood count reports, acute-phase reactants, including C-reactive protein, and erythrocyte sedimentation rate values. The patient group was further divided into two subgroups according to the degree of valvular regurgitation, which included those with severe and those with mild-tomoderate valvular regurgitation. Results: The number of cases with ARC and age-and gendermatched controls were 120 and 50, respectively. The mean age of the patients was 12.25 ± 2.89 (range: 7-18) years. NLR, MPV, anti-streptolysin-O, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), haemoglobin level, and white blood cell (WBC) and neutrophil count were significantly higher in patients with acute carditis compared with the controls (p < 0.001). NLR was found to have a significantly positive correlation with CRP (r = 0.177, p = 0.001), ESR (r = 0.81, p = 0.03) and WBC count (r = 0.47, p = 0.001). Moreover, we found a positive correlation between NLR and severity of valvular regurgitation (r = 0.34, p < 0.001), and a negative correlation between MPV and severity of valvular regurgitation (r =-0.38, p < 0.05) in our patients. In multiple linear regression analysis, severe valvular regurgitation was associated with NLR (0.51; 95% CI: 0.32-0.68; p = 0.006) and MPV (-0.78; 95% CI:-0.72 to-0.98; p = 0.008). Conclusion: NLR and MPV are novel inflammatory markers and simple, rapid and easily accessible prognostic parameters that can be associated with severity of valvular involvement in patients with ARC.

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mentioning

confidence: 99%

The neutrophil-to-lymphocyte ratio and mean platelet volume can be associated with severity of valvular involvement in patients with acute rheumatic carditis

Çelik¹,

Çelik²

2018

CVJA

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“…Consequently, a high NLR represents two immune pathways, making it more predictive than the method used to evaluate either parameter individually [23,29]. Several studies have shown that the white blood cell count and its subtypes, neutrophils and lymphocytes, were associated with the prevalence and severity of CAD and its prognosis [14,15,28,30]. Meta-analysis shows that NLR was an independent predictor of hospitalization, long-term cardiovascular events and cardiac mortality in patients with STsegment elevation MI after PCI [31].…”

Section: Discussionmentioning

confidence: 99%

“…More recently, it has been demonstrated that NLR level is associated with the prevalence and severity of CAD, and the elevated NLR predicts the risk of adverse cardiac events in acute coronary syndrome patients [14,15]. Additionally, higher baseline NLR level was risk factor for the development of in-stent restenosis in CTO patients after PCI [16].…”

Section: Introductionmentioning

confidence: 99%

Impact of Neutrophil-Lymphocyte Ratio on Long-term Outcomes of Patients with Coronary Chronic Total Occlusion After Percutaneous Coronary Intervention

Gao¹,

Li²,

Lei³

et al. 2020

Preprint

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Background: The impact of preprocedural neutrophil-lymphocyte ratio (NLR) level on subsequent adverse cardiovascular events and health status in coronary chronic total occlusion (CTO) patients after stent implantation is unclear. The present study aims to evaluate the impact of NLR level on long-term clinical outcomes and health status of CTO patients after percutaneous coronary intervention (PCI) in the drug eluting stent era.Methods: A total of 311 CTO patients who underwent successful PCI with new-generation drug-eluting stent and with follow-up were enrolled. Patients were classified into 3 groups according to the tertiles of NLR level at baseline. The primary endpoint (major adverse cardiac events, MACE) was a composite of cardiac death, target-vessel myocardial infarction (MI), and ischemia-driven target-vessel revascularization (TVR) on follow-up. Multivariable COX regression analysis was performed to estimate the relationships between the parameters and MACE.Results: Compared with the low and intermediate tertile groups, preprocedural platelet-lymphocyte ratio (PLR) level and age were significantly higher in the high NLR tertile group. After a median follow-up of 32 (interquartile range: 20 to 44) months, MACE was observed in 10 patients (9.7%) in the low tertile, in 21 (20.2%) in the intermediate tertile, and in 31 (29.8%) in the high tertile group (P = 0.001). Kaplan-Meier analysis demonstrated a significantly higher incidence of MACE, mainly driven by TVR, in patients with high tertile than the low and intermediate tertile groups. Multivariable COX regression analysis showed NLR and occluded length as independent predictors of MACE. No statistically differences were observed regarding the five domains of Seattle Angina Questionnaire (SAQ) scores among the 3 groups (all P > 0.05).Conclusions: In conclusion, in patients who underwent PCI for CTO lesions, elevated NLR level was independently associated with MACE (driven by TVR) on follow-up.

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“…The neutrophil-to-lymphocyte ratio (NLR) was first described in 1967 (5) and was reported as an easy metric to assess inflammatory state. There are several studies that give evidence for its efficacy as a predictor of prognosis and/ or mortality in various inflammatory states, such as cancer (6,7), acute coronary syndrome (8)(9)(10), and infections and postoperative complications (11)(12)(13). Numerous previous studies have demonstrated that an increase in NLR is associated with delayed and poor kidney graft function (14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

High neutrophil-to-lymphocyte ratio predicts acute allograft rejection in kidney transplantation: a retrospective study

Ergin¹,

Değer²,

Köprü³

et al. 2019

Turk J Med Sci

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Background/aim: Our research focused on the identification of easily available and sensitive markers for early prediction of acute kidney allograft rejection (AR). We aimed to investigate the association between neutrophil-to-lymphocyte ratio (NLR) and AR in kidney transplant patients. Materials and methods: The medical records of 51 kidney transplant patients [12 female/39 male; median age of 32 (IQR: 24-44) years] were evaluated retrospectively. We considered a cutoff value of >2.5 as high NLR. Results: A total of 22 biopsy-proven AR patients and 29 controls were evaluated. The AR group had a higher NLR compared to the controls (P < 0.001). NLR levels over 2.5 [95% CI: 54.88 (9.96-302.3), P < 0.001] were significantly associated with AR in univariate analysis. The NLR levels were the only significant factor associated with AR in multivariate models, in model 1 (adjusted by age and sex) [95% CI: 114 (11.1-1175), P < 0.001], and in model 2 (adjusted by steroid dosage, uric acid, and NLR) [95% CI: 4.60 (1.59-29.3), P = 0.004]. Conclusion: Our data showed that higher NLR values (>2.5) are associated with AR in kidney transplant patients, leading to the conclusion that NLR might be an easily available and useful marker option for detection of AR in this patient population.

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Neutrophil to lymphocyte ratio predict mortality and major adverse cardiac events in acute coronary syndrome: A systematic review and meta-analysis

Cited by 159 publications

References 28 publications

The neutrophil-to-lymphocyte ratio and mean platelet volume can be associated with severity of valvular involvement in patients with acute rheumatic carditis

The neutrophil-to-lymphocyte ratio and mean platelet volume can be associated with severity of valvular involvement in patients with acute rheumatic carditis

Impact of Neutrophil-Lymphocyte Ratio on Long-term Outcomes of Patients with Coronary Chronic Total Occlusion After Percutaneous Coronary Intervention

High neutrophil-to-lymphocyte ratio predicts acute allograft rejection in kidney transplantation: a retrospective study

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