Utility of the Neutrophil to Lymphocyte Ratio in Predicting Long-Term Outcomes in Acute Decompensated Heart Failure

Uthamalingam, Shanmugam; Patvardhan, Eshan; Subramanian, Sharath; Ahmed, Waleed; Martin, William G.; Daley, Marilyn; Capodilupo, Robert

doi:10.1016/j.amjcard.2010.09.039

Cited by 320 publications

(290 citation statements)

References 27 publications

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“…28) However, there have been no data reported for this parameter in elderly subjects with CHF. The median of the highest tertile value of the N/L ratio in our study was less than 6, possibly because CHF is a chronic systemic syndrome that involves adaptive and compensatory mechanisms.…”

Section: Discussionmentioning

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%

“…28) A higher N/L ratio has also been shown to be associated with an increased risk of in-hospital mortality in patients with acute heart failure. 15,29) In this study, the highest tertile of the N/L ratio was associated with an increased risk of MCE in elderly patients with CHF.…”

Section: Discussionmentioning

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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“…18 It has been found to be a valuable predictor of poor prognosis and long-term mortality in oncological patients, in coronary artery disease, end-stage renal disease and inflammatory diseases such as ulcerative collitis and appendicitis. [19][20][21][22][23][24] When WBC parameter was examined in the current study, there were no significant differences between the patients and the controls in any of the three groups. In the study by Aktas et al and Sagit et al WBC parameter was not different in patients and controls again and both of these studies are supporting our results.…”

Section: Discussionmentioning

confidence: 99%

Study the relationship between nasal polyps, platelet count, mean platelet volume, neutrophil/lymphocyte ratio in patients attending otolaryngology OPD in a tertiary care teaching hospital, West Bengal

Sharma

Raman²,

Ray

et al. 2017

Int J Otorhinolaryngol Head Neck Surg

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Original Research ArticleStudy the relationship between nasal polyps, platelet count, mean platelet volume, neutrophil/lymphocyte ratio in patients attending otolaryngology OPD in a tertiary care teaching hospital, West Bengal ABSTRACTBackground: Nasal obstruction is a common cause of marked nasal septal deviation. It is related strongly with hypoxia. Hypoxic conditions increase mean platelet volume levels. Many studies in literature point out that inflammation related to nasal polyp is mostly dependent on eosinophils and their inflammatory products. Beside eosinophils, platelets may have a role in nasal polyp development. Platelets are involved in hemostasis, tissue repairing and inflammation. Recently, mean platelet volume (MPV) was recognized as a simple inflammatory marker in the inflammatory disease. This study investigated the relationship of nasal polyps with MPV (mean platelet volume), platelet count and NLR (neutrophil to lymphocyte ratio). Methods:The cross-sectional observational study we investigated CBC (complete blood count) parameters of the patients that consulted ENT clinic in a tertiary care teaching hospital, Haldia because of nasal polyp. About 76 patients and 42 controls were included in this study. In all groups, WBC (white blood cell count), RBC (red blood cell count), RDW (red cell distribution width), platelet count, MPV, PDW (platelet distribution width) and NLR parameters from CBC (complete blood count) were compared between patients and controls. Results:Mean WBC values were 6.89±1.33×103/μL in patients with NPs, vs. 7.11±2.32×103/μL in the control group. Mean haemoglobin (Hb) values were 13.19±1.34 g/dL in patients with NPs, vs. 14.1±1.67 g/dl in the control group. Mean MPV values were 9.11 ± 1.08 fL in patients with NPs, vs. 8.32±0.53 fL in the control group. Mean PLT values were 232.38 ± 39.97×103/μL in patients with NPs, vs. 271.44±45.14×103 in the control group. MPV was higher in nasal polyp patients, whereas platelet count was higher in controls. The difference was significant for the mean absolute neutrophil, platelet count, and lymphocyte counts, NLR, PDW and MPV values between the study group and the control group. Conclusions: Platelet count and NLR were significantly lower in patients than the controls, whereas MPV was significantly higher in nasal polyp patients.

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“…In a study that included 300 patients who were admitted to hospital with ACS, higher NLR was associated with higher 30-day in-hospital mortality. 22 Another study reported by Cho et al showed that use of combination of NLR and haemoglobin provided valuable information for early risk stratification in patients with ST elevation myocardial infarction (STEMI). Patients with higher NLR and anaemia had higher mortality rate at six months compared to patients with lower NLR and without anaemia.…”

Section: Discussionmentioning

confidence: 99%

Association between neutrophil to lymphocyte ratio and severity of coronary artery disease

Jagadish

Manjunath

et al. 2018

Int J Adv Med

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Background: Atherosclerosis is a chronic systemic inflammatory disease. Neutrophil-to-lymphocyte ratio (NLR) is systemic inflammatory marker that is correlated with poor cardiovascular outcome. The aim of this study was to investigate the association between neutrophil to lymphocyte ratio (NLR) and severity of coronary atherosclerosis.Methods: A total of 324 patients undergoing coronary angiography were included in the study. All the patients were included in study were divided into two groups based on the result of coronary angiography report. While 226 patients had abnormal coronary angiography (case) (78 female, mean age: 60.6±12.6 years), 98 patients had normal coronary angiography (control) (60 female, mean age: 57.2±10.9 years). NLR was calculated as the ratio of neutrophil count to lymphocyte count.Results: Although age distribution was similar between the two groups(p = 0.073), female gender was significantly higher in the normal coronary angiography group (p < 0.001). Smoking history has shown a significant higher in cases compared to the normal coronary angiography (p=0.001). Patients with abnormal coronary angiography had significantly higher NLR when compared to patients with normal coronary angiography (p<0.001). NLR was significantly correlated with Gensini score. In logistic regression analyses, NLR was an independent predictor of CAD. An NLR of 2.34 or higher predicted the CAD with a sensitivity of 66% and specificity of 70%.Conclusions: There is significant association between severity of coronary artery disease and neutrophils to lymphocyte ratio. This study suggests that the NLR is an independent predictor of coronary heart disease that may be useful for cardiac risk stratification in patients with coronary artery disease.

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Utility of the Neutrophil to Lymphocyte Ratio in Predicting Long-Term Outcomes in Acute Decompensated Heart Failure

Cited by 320 publications

References 27 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

Study the relationship between nasal polyps, platelet count, mean platelet volume, neutrophil/lymphocyte ratio in patients attending otolaryngology OPD in a tertiary care teaching hospital, West Bengal

Association between neutrophil to lymphocyte ratio and severity of coronary artery disease

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