Relative lymphocyte count: A prognostic indicator of mortality in elderly patients with congestive heart failure

Acanfora, Domenico; Gheorghiade, Mihai; Trojano, Luigi; Furgi, Giuseppe; Pasini, Evasio; Picone, C.; Papa, Antimo; Iannuzzi, Gian Luca; Bonow, Robert O.; Rengo, Franco

doi:10.1067/mhj.2001.115792

Cited by 163 publications

(121 citation statements)

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“…31) Meanwhile, a low relative lymphocyte count has been independently associated with an increased mortality rate in patients with heart failure. 10,32) Thus, the N/L ratio, as an integrated reflection of two important immune pathways, is more potent and predictive than either parameter alone. Study limitations: This study has several limitations.…”

Section: Discussionmentioning

confidence: 99%

“…7) Neutrophilia is reported to be associated with an increased incidence of heart failure in patients admitted with acute myocardial infarctions whereas lymphocytopenia has long been recognized to be an independent predictor of poor prognosis in heart failure. [8][9][10] The N/R ratio has been shown to be independently associated with the severity of coronary artery disease in patients with non-ST segment elevation myocardial infarction, and the ability of the N/L ratio to predict cardiovascular risk in various patient groups has been analyzed in several studies, including in patients with CKD. 7,[11][12][13][14][15][16] However, to date, the N/L ratio has not been investigated in elderly patients with CHF.…”

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confidence: 99%

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Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting Adverse Events in Elderly Patients With Chronic Heart Failure

Yan

et al. 2016

Int. Heart J.

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SummaryThe neutrophil-to-lymphocyte (N/L) ratio has been associated with poor outcomes in patients with cardiovascular diseases, but it has not been studied in elderly patients with chronic heart failure (CHF).In this study, we analyzed 1355 elderly patients admitted with CHF. A multivariate logistic regression model was used to assess the independent association of the N/L ratio with chronic kidney disease (CKD). The patients were then divided into tertiles according to the N/L ratios. We used Cox regression analysis to assess the association between the N/L ratio and subsequent major cardiovascular events (MCE), including cardiac death and rehospitalization for heart failure.In the multiple logistic regression analysis, the N/L ratio was identified as a risk factor for CKD in elderly patients with CHF (odds ratio [OR] = 1.170, 95% confidence interval [CI] 1.054 to 1.298, P = 0.003). The median follow-up period was 18 months. In a multivariate analysis with the lowest tertile as the reference, the highest tertile of the N/L ratio remained significantly associated with MCE (hazard ratio [HR] = 1.425, 95% CI 1.109 to 1.832, P = 0.006), cardiac death (HR = 1.747, 95% CI 1.032 to 2.958, P = 0.038), and rehospitalization for heart failure (HR = 1.461, 95% CI 1.108 to 1.927, P = 0.007).In elderly patients with CHF, the N/L ratio is one of the important risk factors for CKD and the highest tertile of the N/L ratio is associated with an increased risk for MCE. (Int Heart J 2016; 57: 615-621)

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting Adverse Events in Elderly Patients With Chronic Heart Failure

Yan

et al. 2016

Int. Heart J.

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“…Relation between neutrophil/lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), relative lymphocyte count (L%), and heart failure aetiology according to response to cardiac resynchronisation therapy count [18,19]. Previous studies have shown that relative lymphocyte count was significantly associated with incident HF, hospitalisations due to HF, and mortality [20][21][22]. Neutrophils play a major role in the inflammatory process, by producing myeloperoxidase that promotes phagocytic function.…”

Section: Discussionmentioning

confidence: 99%

The role of baseline indirect inflammatory markers in prediction of response to cardiac resynchronisation therapy

Balcı

Şen

et al. 2016

Kardiol Pol

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A b s t r a c tBackground: In many cardiovascular diseases (CVD), white blood cell counts with differentials are used to predict adverse events. Both platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are studied in various CVDs. Aim:The role of inflammatory condition assessed using routine laboratory tests in cardiac resynchronisation therapy (CRT) response has not been investigated thoroughly. Therefore, we aimed to assess the association of NLR, PLR, and relative lymphocyte count (L%) with response to CRT. Methods:A total of 157 patients (76.4% male; mean age 58.7 ± 11.8 years) who underwent CRT implantation at our tertiary referral hospital were retrospectively analysed.Results: Among included patients, a total of 50 (31.8%) patients were defined as "non-responders". Median NLR and PLR were significantly higher in the non-responder group (p < 0.001), and median L% was significantly lower in the non-responder group (p < 0.001). Also, median NLR was significantly higher in patients with New York heart Association (NYHA) class II-III when compared to patients with NYHA class I after six months of CRT implantation (p < 0.001, p = 0.004, respectively). Correlation analysis demonstrated a positive correlation between paced QRS duration and NLR (p = 0.031) and a negative correlation between paced QRS duration and L% (p = 0.002). In addition, both NLR and L% showed significant correlations with post-procedural NYHA functional classes (p < 0.001; p = 0.008, respectively). Patients with PLR > 173.09 had a 2.9-fold and NLR > 3.45 had a 12.2-fold increased risk of CRT nonresponse, respectively. Conclusions:In the current study non-responders to CRT had higher NLR and PLR and lower L%, which may support the deleterious effects of baseline inflammatory condition in advanced heart failure.

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“…Aterosklerozun başlangıcında ve progresyonunda artmış trombosit aktivasyonunun önemli bir etkisi vardır (37). Diğer taraftan, periferik kanda düşük lenfosit sayısı majör olumsuz kardiyovasküler hastalıklarla ilişkili bulunmuştur (38,39). PLR, her iki hematolojik göstergeyi birleştiren yeni bir marker olarak bulunmuştur.…”

Section: Gereç Ve Yöntemlerunclassified

The relationship between TIMI flow grade and hematological parameters in patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention

Oylumlu¹,

Doğan²,

Ercan³

et al. 2014

Gaziantep Med J

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The relationship between TIMI flow grade and hematological parameters in patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention ST- Abstract ST-segment elevation myocardial infarction (STEMI) is among the most important causes of mortality and morbidity. The relationship between hematological parameters and cardiovascular diseases is well known. In patients with STEMI, ensuring blood flow in infarct-related artery at early stages improves ventricular performance and reduces mortality. In our study, we aimed to reveal the relationship between the blood flow in infarct-related artery thrombolysis in myocardial infarction (TIMI) flow and hematologic parameters in patients presenting with acute STEMI and having coronary angiography and revascularization. Our study has a retrospective observational design. One hundred and forty one patients, 108 male and 33 female, who presented with acute STEMI and underwent percutaneous coronary intervention (PCI), participated in our study which was based on one center. The patients were divided into two groups; namely the spontaneous recanalization of the infarct related artery and totally occluded infarct related artery. The relationship between hematological parameters and TIMI flow was investigated. Red cell distribution width (RDW), neutrophillymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) values in the group of patients with totally occluded infarct related artery were found significantly higher than the group of patients with spontaneous recanalization [respectively, 13.8 (13.1 -15.2) vs. 13.6 (13.1 -14.3); P=0.041, 4.0 (2.3 -7.8) vs. 2.9 (1.8 -4.9); P=0.002, 123.0 (74.6 -237.4) vs. 112.3 (79.2 -149.3) P=0.013]. The multivariate logistic regression analysis revealed a relation between elevated NLR and RDW values and total occlusion of infarct related artery. In our study, we found that hematological parameters, NLR and RDW, were independent predictors of patency of infarct related artery in patients with STEMI. Keywords: Coronary artery disease; hematological parameters; myocardial infarction Özet ST-segment elevasyonlu miyokard enfarktüsü (STEMI), koroner arter hastalığında mortalite ve morbiditenin önemli bir nedenidir. Kardiyovasküler hastalıklar ile hematolojik parametreler arasındaki ilişki bilinmektedir. STEMI'lı hastalarda, infarktüsten sorumlu olan damarın kan akımının erken dönemde sağlanması ventrikül performansını artırır ve mortaliteyi azaltır. Çalışmamızda, akut STEMI ile başvuran ve revaskülarizasyon amaçlı koroner anjiografileri yapılan hastalarda, infarktüsten sorumlu damar akımı ile miyokard infarktüsünde tromboliz akım (TIMI) hematolojik parametreler arasında bir ilişki olup olmadığını amaçladık. Çalışmamız retrospektif gözlemsel bir çalışmadır. Tek merkezde yapılan çalışmamıza, akut STEMI ile başvuran ve perkutan koroner girişim (PCI) yapılan 108 erkek, 33 kadın olmak üzere toplam 141 hasta alınmıştır. Hastalar infarktüsten sorumlu arteri spontan rekanalize olanlar ile total tıkalı olan...

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Relative lymphocyte count: A prognostic indicator of mortality in elderly patients with congestive heart failure

Cited by 163 publications

References 44 publications

Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting Adverse Events in Elderly Patients With Chronic Heart Failure

Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting Adverse Events in Elderly Patients With Chronic Heart Failure

The role of baseline indirect inflammatory markers in prediction of response to cardiac resynchronisation therapy

The relationship between TIMI flow grade and hematological parameters in patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention

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