Red cell distribution width and neutrophil-to-lymphocyte ratio predict left ventricular dysfunction in acute anterior ST-segment elevation myocardial infarction

Karakaş, Mustafa Serkan; Korucuk, Necmettin; Tosun, Veysel; Altekin, Refik Emre; Koç, Fatih; Özbek, Sinan Cemgil; Özel, Deniz; Ermis, Cengiz

doi:10.1016/j.jsha.2015.07.001

Cited by 37 publications

(30 citation statements)

References 36 publications

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“…The neutrophil-to-lymphocyte ratio (NLR), determined as the ratio of absolute neutrophil count to lymphocyte count, is a novel inflammatory biomarker used as a prognostic factor in various diseases [24]. It has been previously studied [25][26][27][28], but in light of the racial and ethnic differences found in NLR [29], more studies examining these relationships in different populations should be conducted. Although several studies have investigated the effect of dietary patterns, anthropometric measurements, or metabolic parameters on inflammatory markers, studies using the NLR as an inflammation indicator are not common.…”

Section: Introductionmentioning

confidence: 99%

Association between Neutrophil-to-Lymphocyte Ratio with Abdominal Obesity and Healthy Eating Index in a Representative Older Spanish Population

et al. 2020

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Poor diet quality and obesity, especially abdominal obesity, have been associated with systemic inflammation. The neutrophil-to-lymphocyte Ratio (NLR) is an available and inexpensive inflammation biomarker. The aim of the present study was to determine the association of dietary patterns and obesity with an inflammatory state. A group of 1747 Spanish noninstitutionalized older adults individuals were included, and a food-frequency questionnaire was applied. The Global Food Score (GFS) and Healthy Eating Index for Spanish population (SHEI) were calculated. Weight, height and waist (WC) and hip circumferences were measured, and BMI, waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR) determined. In addition, body-fat percentage was measured by bioimpedance. NLR was calculated (NLR ≥ p80: 2.6; 2.8 and 2.4 as inflammatory status in the entire population, men and women, respectively). The men with inflammatory status presented significative higher values of WC, WHtR, WHR, and body-fat percentage (101.82 ± 10.34 cm, 0.61 ± 0.06, 0.98 ± 0.06, and 31.68 ± 5.94%, respectively) than those with better inflammatory status (100.18 ± 10.22 cm, 0.59 ± 0.06, 0.97 ± 0.07, and 30.31 ± 6.16%, respectively). Those males with worse inflammatory state had lower scores for protein foods (OR = 0.898 (0.812–0.993); p = 0.037). The women with NLR ≥ 2.4 had higher WHtR and WHR (0.62 ± 0.09 and 0.91 ± 0.09) than those with NLR < 2.4 (0.60 ± 0.08 and 0.90 ± 0.08). In multiple linear regression analysis, NLR was positively related with WHtR and negatively related with SHEI score (β = 0.224 ± 0.094; R2 = 0.060; p < 0.05 and β = −0.218 ± 0.101; R2 = 0.061; p < 0.05), adjusting by sex, age, marital status, education level, smoking, hours of sleeping and inflammatory diseases. In women, the higher the SHEI and GFS scores were and the better meeting the aims of cereal and vegetable servings, the less the odds of inflammatory status (OR = 0.970 (0.948–0.992); p = 0.008; OR = 0.963 (0.932–0.995); p = 0.024; OR = 0.818 (0.688–0.974); p = 0.024 and OR = 0.829 (0.730–0.942); p = 0.004, respectively). WHtR and quality of diet is related to the inflammation status in older adults regardless to the sex.

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Section: Introductionmentioning

confidence: 99%

Association between Neutrophil-to-Lymphocyte Ratio with Abdominal Obesity and Healthy Eating Index in a Representative Older Spanish Population

et al. 2020

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“…Hence, the predictive performance of these biomarkers on the outcomes was limited. More recently, several efficient biomarkers, including gamma-glutamyl transferase (GGT) [25,26], GGT-to-platelet ratio (GPR) [27], mean platelet volume (MPV) [28,29], red blood cell distribution width (RDW) [30,31], and monocyte-to-HDL-C ratio [32], emerged. ALT, mainly derived from the liver, was considered as a marker of liver function.…”

Section: Discussionmentioning

confidence: 99%

ALT-to-Lymphocyte Ratio as a Predictor of Long-Term Mortality in Patients with Normal Liver Function Presenting Coronary Artery Disease after Undergoing PCI: A Retrospective Cohort Study

Zheng

Guo

Tang

et al. 2020

Journal of Interventional Cardiology

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Background. Alanine aminotransferase (ALT) is referred as liver transaminase and predominantly expressed by hepatocytes. Previous evidences showed that high levels of ALT were reversely associated with short- and long-term outcomes in patients with myocardial infarction. Besides, low lymphocyte has been demonstrated to be significantly correlated with adverse clinical outcomes in coronary artery disease (CAD). However, evidences about the relationship between ALT-to-lymphocyte ratio (ALR) and outcomes in CAD patients with normal liver function are limited. The aim of this study was to assess the relationship between ALR and clinical outcomes in patients with CAD. Methods. This is a retrospective cohort study, and a total of 3561 patients were enrolled in Clinical Outcomes and Risk Factors of Patients with CAD after percutaneous coronary intervention (PCI), from January 2013 to December 2017. After excluding patients with liver dysfunction, we finally enrolled 2714 patients. These patients were divided into two groups according to ALR value: the lower group (ALR < 14.06, n = 1804) and the higher group (ALR ≥ 14.06, n = 910). The average follow-up time was 37.59 ± 22.24 months. Results. We found that there were significant differences between the two groups in the incidence of all-cause mortality (ACM) (P<0.001) and cardiac mortality (CM) (P=0.010). Kaplan–Meier survival analysis suggested that CAD patients with higher ALR tended to have an increased accumulated risk of ACM and CM (log rank P<0.001 and P=0.006, respectively). Multivariate Cox regression analysis showed that ALR was an independent predictor of ACM (hazard ratio (HR) = 2.017 (95% confidence interval (CI): 1.289–3.158), P=0.002) and CM (HR = 1.862 (95% CI: 1.047–3.313), P=0.034). We did not find significant difference in the incidence of major adverse cardiovascular events (MACEs) and major adverse cardiovascular and cerebrovascular events (MACCEs) between the two groups after adjustments of confounders. Conclusion. Our results indicate that ALR is an independent predictor of long-term adverse outcomes in CAD patients who underwent PCI.

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“…21 karakaset al, divided patientsinto two groups according to LVEF and there RDW (red cell distribution width) and NLR were assessed at time of admission.Group 1 (systolic dysfunction, LVEF<50%) and Group 2 (preserved global systolic function, LVEF>50%), concludes that mean RDW and NLR were significantly higher in group 1 patients. 22 Zhang et al demonstrated that hemoglobin, neutrophil/ lymphocyte ratio (NLR), Global Registry of Acute Coronary Event score, and post procedure left ventricular ejection fraction (LVEF) were independent predictors of MACEs. 23 But Abrel et al concluded that high NLR was independently associated with lower ejection fraction (49+8 vs 46+8; P<0.001) and fewer hospital complications.…”

Section: Discussionmentioning

confidence: 99%

The prognostic value of total neutrophil count, neutrophil/lymphocyte ratio and left ventricular ejection fraction in predicting in- hospital mortality and complications after acute STEMI

Malik¹,

Chander²,

Singh³

et al. 2017

Int. J. Curr. Res. Biol. Med.

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Background: Leukocytosis, predominantly neutrophilia has previously been described following ST elevation myocardial infarction (STEMI). The exact contribution of this phenomenon to the clinical outcome of STEMI is yet to be shown. We examined cellular inflammatory response to STEMI in the blood by assessing total neutrophil count (TNC), neutrophil to lymphocyte ratio (NLR) and Left ventricular ejection fraction (LVEF) post myocardial infarction and their association with inhospital mortality and/or adverse clinical events. Methods: In this cross-sectional study, 50 patients who were admitted with the diagnosis of acute STEMI at Government medical college and Hospital, Amritsar were studied. The complete blood cell count (CBC) was done in all patients within12-24 hours of the onset of symptoms. Total leukocyte count and differential leukocyte count were performed and neutrophil/lymphocyte ratio (NLR) was calculated. Left ventricular ejection fraction was assessed within one week of MI. Association of cellular response and ejection fraction with the incidence of post-MI mortality/complications like pulmonary edema, cardiogenic shock, arrhythmias and blocks were assessed by using ROC curve analysis and chi square test. Results: In-hospital mortality and post-STEMI complication rate were 8% and 42%, respectively. Total neutrophil count (P=0.029) and Neutrophil to lymphocyte ratio (P=0.001) were predictors of mortality. High NLR (P<0.001) and lower LVEF (P<0.001) were predictors of total complications and cardiogenic shock. Pump failure in the form of acute pulmonary edema (6%) or cardiogenic shock (8%) occurred in 7 (14%) patients. Higher total neutrophil counts (P=0.009), higher NLR (P<0.001) and lower ejection fraction (P<0.001) were predictors of pulmonary edema. The frequency of ventricular tachyarrhythmias (VT/VF) at the first day was associated with higher NLR level (P=0.029).High TNC and low LVEF were predictors for first degree heart block and high NLR was predictor for third degree heart bock and left bundle branch block. Conclusion: A single CBC analysis along with routinely assessed parameter i.e. ejection fraction may help to identify STEMI patients at risk for mortality and heart failure, while neutrophil to lymphocyte ratio is the most valuable in predicting both.

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Red cell distribution width and neutrophil-to-lymphocyte ratio predict left ventricular dysfunction in acute anterior ST-segment elevation myocardial infarction

Abstract: Increased RDW and NLR on admission, in anterior STEMI patients treated with primary PCI are associated with LV systolic dysfunction.

Cited by 37 publications

References 36 publications

Association between Neutrophil-to-Lymphocyte Ratio with Abdominal Obesity and Healthy Eating Index in a Representative Older Spanish Population

Association between Neutrophil-to-Lymphocyte Ratio with Abdominal Obesity and Healthy Eating Index in a Representative Older Spanish Population

ALT-to-Lymphocyte Ratio as a Predictor of Long-Term Mortality in Patients with Normal Liver Function Presenting Coronary Artery Disease after Undergoing PCI: A Retrospective Cohort Study

The prognostic value of total neutrophil count, neutrophil/lymphocyte ratio and left ventricular ejection fraction in predicting in- hospital mortality and complications after acute STEMI

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