Prognostic value of hematological parameters in patients with acute myocardial infarction: Intrahospital outcomes

Abstract

BackgroundThe intensity of the inflammatory response and hemodynamic repercussion in acute myocardial infarction causing the presence in the peripheral circulation of nucleated red blood cells (NRBCs), increases in mean platelet volume (MPV) and neutrophil to lymphocyte ratio (NLR) are associated with a poorer prognosis. The aim of this study was to assess the role of these hematological biomarkers as predictors of all causes of mortality during the hospitalization of patients with acute myocardial infarction.MethodsNucleated red blood cells, mean platelet volume and neutrophil to lymphocyte ratio were measured daily during the hospitalization of the patients with acute myocardial infarction. We excluded patients younger than 18 years, on glucocorticoid therapy, with cancer or hematological diseases and those that were readmitted after hospital discharge. We performed a multiple logistic analysis to identify independent predictors of mortality.ResultsWe included 466 patients (mean age 64.2 ± 12.8 years, 61.6% male). The prevalence of NRBCs in the sample was 9.1% (42 patients), with levels > 200/μL in 27 patients (5.8%). The mean MPV value was 10.9 ±0,9 and the mean NLR value was 3.71 (2,38; 5,72). In a multivariate analysis of serum NRBCs (HR 2.42, 95% CI: 1.35–4.36, p = 0.003), MPV (HR 2.97, 95% CI: 1.15–7.67, p = 0.024) and NLR (HR 5.02, 95% CI: 1.68–15.0, p = 0.004). The presence in the peripheral blood of NRBCs, increased in mean platelet volume and neutrophil to lymphocyte ratio were associated with higher mortality.ConclusionsNucleated red blood cells, mean platelet volume and neutrophil to lymphocyte ratio are independent predictors of intrahospital mortality. Therefore, an important tool in intrahospital clinical surveillance.

Prognostic implications of post-percutaneous coronary intervention neutrophil-to-lymphocyte ratio on infarct size and clinical outcomes in patients with acute myocardial infarction

“…Based on this concept, several studies have investigated the associations between various inflammatory markers and clinical outcomes in patients with coronary artery disease 4–8 . Neutrophil-to-lymphocyte ratio (NLR) has emerged as an independent predictor of cardiovascular outcomes in patients with ischemic heart disease, including AMI 9–15 . Especially, post-percutaneous coronary intervention (PCI) NLR was found to be a better indicator of severity of myocardial damage than pre-PCI NLR 12–14 .…”

Hematological Parameters as Prognostic Biomarkers in Patients with Cardiovascular Diseases

“…Monteiro Junior et al . [ 8 ] associated increased NRBC, MPV and NRL in peripheral blood with higher in-hospital mortality in patients with acute myocardial infarction. Therefore, they considered these variables an important in-hospital tool of clinical surveillance.…”

“…Previous studies have demonstrated the prognostic value of these hematological parameters in stroke [ 5 , 6 ], coronary artery disease [ 7 , 8 ], heart failure [ 9 , 10 ], systemic arterial hypertension [ 11 , 12 ], atrial fibrillation [ 13 ] and cardiovascular disease associated with septicemia [ 3 , 14 ]. Therefore, it is important to review these blood cells count as potential clinical analyzers (Table 2 ) [ 15 ].…”

Association of Neutrophil to Lymphocyte Ratio with Disease Severity and Joint Effusion in Patients with Early Stage Knee Osteoarthritis

“…NLR was determined as the ratio between the absolute number of neutrophils and lymphocytes obtained from routine hematology panels retrieved from the hospital's electronic records [8,9]. Tests were determined using Nihon Kohden Celltac 6500, Sysmex XT-4000i or ADVIA 2120 analyzers.…”

“…It has been proven as a negative outcome predictor in gastrointestinal cancers, cardiovascular events [7,8]. However, studies on fractures, OA and inflammatory arthritis did not bring consistent results [9][10][11][12][13][14].…”