scholarly journals Neutrophil-to-lymphocyte ratio for predictor of in-hospital mortality in ST-segment elevation myocardial infarction: a meta-analysis

2020 ◽  
Vol 29 (2) ◽  
pp. 172-82
Author(s):  
Rodry Mikhael ◽  
Evan Hindoro ◽  
Sharleen Taner ◽  
Antonia Anna Lukito
Keyword(s):  
Myocardial Infarction ◽  
Hospital Mortality ◽  
Meta Analysis ◽  
Neutrophil To Lymphocyte Ratio ◽  
St Segment Elevation ◽  
Lymphocyte Ratio ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
All Cause Mortality

BACKGROUND ST-segment elevation myocardial infarction (STEMI) is the most life-threatening condition of acute coronary syndrome that carries a poor prognosis of in-hospital mortality. Multiple scoring systems have been developed to predict in-hospital mortality and other cardiovascular events. Neutrophil-to-lymphocyte ratio (NLR) is hardly used as a predictor of in-hospital mortality. This study was aimed to determine the predictive value of NLR concerning in-hospital mortality in STEMI patients. METHODS Literature search and pooled analysis related to studies on MEDLINE/PubMed, EBSCO, Science Direct, Cochrane, and ProQuest were retrieved. Inclusion criteria were met if they were cohort studies, the subjects were STEMI patient, contained pretreatment NLR cut-off, and considered in-hospital mortality, which is defined as cardiac or all-cause mortality. Quality assessment was conducted using Newcastle-Ottawa scale. Review Manager version 5.3 (The Nordic Cochrane Centre, Copenhagen) was used for meta-analysis. RESULTS We found 12 studies with a total of 7,251 STEMI subjects with median NLR cut-off value of 5.6. Elevated NLR on admission carries a high risk of in-hospital mortality (odds ratio [OR] = 3.00, 95% confidence interval [CI] = 2.46–3.67). A slightly higher risk of all-cause mortality (OR = 2.74, 95% CI = 1.99–3.77) was observed compared with cardiac-related mortality (OR = 3.20, 95% CI = 2.47–4.14). No significant heterogeneity was observed between these studies (p = 0.46, I2 = 0%). CONCLUSIONS Elevated NLR predicts a higher in-hospital mortality rate of STEMI patients.

Comparing the Prognostic Value of Hematological Indices in Patients With ST Segment Elevation Myocardial Infarction: “A Head to Head” Analysis

Angiology ◽  
2020 ◽  
pp. 000331972097775
Author(s):  
Serhat Sigirci ◽  
Özgür Selim Ser ◽  
Kudret Keskin ◽  
Süleyman Sezai Yildiz ◽  
Ahmet Gurdal ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Hematological Indices ◽  
St Segment Elevation ◽  
Lymphocyte Ratio ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Long Term Mortality

Although there are reviews and meta-analyses focusing on hematological indices for risk prediction of mortality in patients with ST segment elevation myocardial infarction (STEMI), there are not enough data with respect to direct to head-to-head comparison of their predictive values. We aimed to investigate which hematological indices have the most discriminatory capability for prediction of in-hospital and long-term mortality in a large STEMI cohort. We analyzed the data of 1186 patients with STEMI. In-hospital and long-term all-cause mortality was defined as the primary end point of the study. In-hospital mortality rate was 8.6% and long-term mortality rate 9.0%. Although the neutrophil to lymphocyte ratio (NLR) and age were found to be independent predictors of in-hospital mortality in the multivariate regression analyses; Cox regression analysis revealed that age, ejection fraction, red cell distribution width (RDW), and monocyte to high-density lipoprotein ratio (MHDLr) were independently associated with long-term mortality. Neutrophil to lymphocyte ratio had the highest area under curve value in the receiver operating characteristic curve analyses for prediction of in-hospital mortality. In conclusion, while NLR may be used for prediction of in-hospital mortality, RDW and MHDLr ratio are better hematological indices for long-term mortality prediction after STEMI than other most common indices.

scholarly journals The prediction of cardiac events in patients with acute ST segment elevation myocardial infarction: A meta–analysis of serum uric acid

2018 ◽  
Vol 13 (1) ◽  
pp. 413-421
Author(s):  
Hailong Wang ◽  
Jianjun Yang ◽  
Jiang Sao ◽  
Jianming Zhang ◽  
Xiaohua Pang
Keyword(s):  
Myocardial Infarction ◽  
Uric Acid ◽  
Hospital Mortality ◽  
Serum Uric Acid ◽  
Meta Analysis ◽  
Systematic Analysis ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
One Year

AbstractObjectiveThe current study aimed to explore the predictive ability of serum uric acid (SUA) in patients suffering from acute ST segment elevation myocardial infarction (STEMI).MethodPubMed, EMBASE, Cochrane Library, and Medline databases were systematically searched from their respective inceptions to February 2018. Systematic analysis and random-effects meta–analysis of prognostic effects were performed to evaluate STEMI outcomes [i.e., in-hospital mortality, one-year mortality, in-hospital Major Adverse Cardiovascular Events (MACE)] in relation to SUA.ResultsA total of 12 studies (containing 7,735 patients with acute STEMI) were identified (5,562 low SUA patients and 3,173 high SUA patients). Systematic analysis of these studies showed that high SUA patients exhibited a higher incidence of in-hospital MACE (OR, 2.30; P < 0.00001), in-hospital mortality (OR, 3.03; P < 0.0001), and one-year mortality (OR, 2.58; P < 0.00001), compared with low SUA patients.ConclusionsAcute STEMI patients with high SUA exhibited an elevated incidence rate of in-hospital MACE, in-hospital mortality, and one-year mortality. Further randomized controlled trials will be needed to verify these results.

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