The neutrophil to lymphocyte ratio is associated with severity of rheumatic mitral valve stenosis

Abstract

BackgroundRheumatic heart disease (RHD) is a serious health concern in developing countries. Rheumatic mitral stenosis (RMS) is the most long-term sequel in RHD. The neutrophil to lymphocyte ratio (NLR) is a novel marker, and a higher NLR has been associated with poor clinical outcomes in various cardiovascular disorders. We evaluated the availability of NLR to predict severity of mitral stenosis (MS) in patients with RHD.MethodsWe analyzed 300 consecutive patients with RMS. The patients were divided into tertiles according to NLR: 0.85< NLR ≤1.85 (n=100, tertile 1), 1.86≤ NLR ≤2.46 (n=100, tertile 2), and 2.47≤ NLR ≤7.08 (n=100, tertile 3). Patients with RMS were divided into three groups based on the degree of MS as mild, moderate, and severe MS. After the initial evaluation, 187 patients with moderate-to-severe RMS (Group 1) and 113 patients with mild RMS (Group 2) were reassessed.ResultsThe patients with severe RMS had significantly elevated NLR, mean platelet volume, and pulmonary artery systolic pressure values compared to patients with moderate and mild MS (P<0.001, P<0.001, P<0.001 respectively). Multivariate binary logistic regression analysis revealed that high levels of NLR was an independent predictor of severe RMS (odds ratio =0.68, P=0.008). Moderate-to-severe RMS incidence was significantly higher among patients in the tertile 3 (odds ratio =2.8, P=0.001).ConclusionNLR is a new inflammatory marker and a simple, rapid, and easily accessible prognostic parameter that can be associated with severity of RMS in patients with RHD.

Are there any novel markers in acute rheumatic fever: neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio

“…[13][14][15] There are some studies in the literature correlating the increase in neutrophil-to-lymphocyte ratio with the severity of valvular involvement in patients with acute rheumatic carditis, whereas some others comparing the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios of patients with newly diagnosed acute rheumatic fever before and after treatment had no significant differences. [16][17][18] In this study, both neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios were found to be higher in patients with acute rheumatic fever when compared to the control group. These measured markers are accepted as novel indicators of the continuing inflammation in acute rheumatic fever.…”

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

“…21 Baysal et al revealed that high levels of NLR were an independent predictor of severe RMS. 22 In a recent study, it was reported that patients with severe RMS had significantly higher NLRs than those with mild-to-moderate RMS. 23 In addition, higher NLRs were associated with an increased risk of long-term mortality in patients admitted with acute decompensated heart failure.…”

Neutrophil‐to‐lymphocyte ratio can specifically predict the severity of hypertriglyceridemia‐induced acute pancreatitis compared with white blood cell

“…During recent years, neutrophil‐to‐lymphocyte ratio (NLR) has been proved of great value with a significant correlation with systemic inflammation reaction in several autoimmune diseases . Because NLR can be easily obtained at low cost through an automatic hematology analyzer, many research groups have further confirmed the value of NLR in predicting disease severity and worse clinical outcomes in a variety of diseases, including cerebrovascular diseases, cardiovascular diseases, and neoplasm .…”