scholarly journals Variability in blood lipid affects the neutrophil to lymphocyte ratio in patients who have undergone elective percutaneous coronary intervention: A retrospective study

2020 ◽  
Author(s):  
Liding Zhao ◽  
Tian Xu ◽  
Ya Li ◽  
Yi Luan ◽  
Qingbo Lv ◽  
...  

Abstract Background Atherosclerosis is associated with chronic inflammation and lipid metabolism. The neutrophil to lymphocyte ratio (NLR) as an indicator of inflammation has been confirmed to be associated with cardiovascular disease prognosis. However, few studies have explored the effects of blood lipid variability on NLR. We aimed to explore the relationship between variability in blood lipid levels and NLR. Methods The association between variability in blood lipids and NLR was assessed with both univariate and multivariate linear regression. Multivariate linear regression was also performed for a subgroup analysis. Results The variability of HDL-C ([ꞵ] 4.008, SE 0.503, p-value<0.001) and LDL-C ([ꞵ] 0.626, SE 0.164, p-value<0.001) were risk factors for the NLR value, although baseline LDL-C and HDL-C were not risk factors for NLR values. Variability of HDL-C ([ꞵ] 4.328, SE 0.578, p-value<0.001) and LDL-C ([ꞵ] 0.660, SE 0.183, p-value<0.001) were risk factors for NLR variability. Subgroup analysis demonstrated that the relationship between variability of LDL-C and NLR was consistent with the trend of the total sample for those with or without diabetes mellitus, controlled blood lipid, statins, atorvastatin or rosuvastatin. The relationship between the variability of HDL-C and NLR was consistent with the trend of the total sample in all subgroups. Conclusion The variability of HDL-C and LDL-C are risk factors for the value and variability of NLR, while the relationship between variability of HDL-C and NLR is more stable than the variability of LDL-C in the subgroup analysis.

2020 ◽  
Author(s):  
Liding Zhao ◽  
Tian Xu ◽  
Ya Li ◽  
Yi Luan ◽  
Qingbo Lv ◽  
...  

Abstract Background: Atherosclerosis is associated with chronic inflammation and lipid metabolism. The neutrophil to lymphocyte ratio (NLR) as an indicator of inflammation has been confirmed to be associated with cardiovascular disease prognosis. However, few studies have explored the effects of blood lipid variability on NLR. The aim of this study was to explore the relationship between variability in blood lipid levels and NLR. Methods: The association between variability in blood lipids and NLR was assessed with both univariate and multivariate linear regression. Multivariate linear regression was also performed for a subgroup analysis. Results: The variability of high-density lipoprotein cholesterol (HDL-C) (regression coefficients [β] 4.008, standard error (SE) 0.503, P-value<0.001) and low-density lipoprotein cholesterol (LDL-C) ([β] 0.626, SE 0.164, P-value<0.001) were risk factors for the NLR value, although baseline LDL-C and HDL-C were not risk factors for NLR values. Variability of HDL-C ([β] 4.328, SE 0.578, P-value<0.001) and LDL-C ([β] 0.660, SE 0.183, P-value<0.001) were risk factors for NLR variability. Subgroup analysis demonstrated that the relationship between variability of LDL-C and NLR was consistent with the trend of the total sample for those with diabetes mellitus, controlled blood lipid, statins, atorvastatin. The relationship between the variability of HDL-C and NLR was consistent with the trend of the total sample in all subgroups. Conclusion: The variability of HDL-C and LDL-C are risk factors for the value and variability of NLR, while the relationship between variability of HDL-C and NLR is more stable than the variability of LDL-C in the subgroup analysis, which provides a new perspective for controlling inflammation in patients undergoing PCI.


2021 ◽  
Vol 13 (3) ◽  
pp. 216-221
Author(s):  
Mehdi Maleki ◽  
Arezou Tajlil ◽  
Ahmad Separham ◽  
Bahram Sohrabi ◽  
Leili Pourafkari ◽  
...  

Introduction: Considering the role of inflammation in pathogenesis of atherosclerosis, we aimed to investigate the association of presentation neutrophil to lymphocyte ratio (NLR) with complexity of coronary artery lesions determined by SYNTAX score in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). Methods: From March 2018 to March 2019, we recruited 202 consecutive patients, who were hospitalized for NSTE-ACS and had undergone percutaneous coronary intervention in our hospital. The association of presentation NLR with SYNTAX score was determined in univariate and multivariate linear regression analysis. Results: Higher NLR was significantly associated with higher SYNTAX score (beta= 0.162, P=0.021). In addition, older age, having hypertension, higher TIMI score, and lower ejection fraction on echocardiographic examination were significantly associated with higher SYNTAX score. TIMI score had the largest beta coefficient among the studied variables (TIMI score beta=0.302, P<0.001). In two separate multivariate linear regression models, we assessed the unique contribution of NLR in predicting SYNTAX score in patients with NSTE-ACS. In the first model, NLR was significantly contributed to predicting SYNTAX score after adjustment for age, sex, and hypertension as covariates available on patient presentation (beta=0.142, P=0.040). In the second model, NLR was not an independent predictor of SYNTAX score after adjustment for TIMI score (beta=0.121, P=0.076). Conclusion: In NSTE-ACS, presentation NLR is associated with SYNTAX score. However, NLR does not contribute significantly to the prediction of SYNTAX score after adjustment for TIMI score. TIMI risk score might be a better predictor of the SYNTAX score in comparison to NLR.


2021 ◽  
Vol 18 ◽  
Author(s):  
Jiawei Zhao ◽  
Kai Liu ◽  
Shen Li ◽  
Yuan Gao ◽  
Lu Zhao ◽  
...  

Background: Increasing evidences suggest that neutrophil-to- lymphocyte ratio (NLR) is an independent predictor of poor prognosis in patients with cardiovascular disease. However, the relationship between NLR and prognosis in patients with cerebral venous thrombosis (CVT) has not been studied. Methods: Consecutive CVT patients from November 2011 through April 2019 were retrospectively identified. Poor outcome was defined as modified Rankin Scale (mRS) of 3-6. Multivariate regression analysis was conducted to assess the relationship between total and differential leukocyte counts, NLR and clinical outcome in CVT patients. The receiver operating characteristic (ROC) analysis was further performed to evaluate the ability to predict mortality and subgroup analysis was conducted to explore the potential interaction effects. Results: A total of 360 CVT patients were included and the median duration of follow-up was 9.0 months. Multivariate logistic regression analysis suggested that NLR value, as a continuous variable, was significantly associated with a high risk of poor outcome (adjusted odds ratio [OR]=1.06, 95% confidence intervals [CI] 1.01-1.11, P = 0.013) and mortality (adjusted OR = 1.08; 95% CI, 1.03-1.14; P = 0.002). Compared with the total and differential leukocyte counts, the best discriminating variable to predict the risk of mortality was NLR and the area under the receiver operating curve was 0.81. The optimal cut-off value of NLR to predict mortality was 5.6 (sensitivity 84.2%, specificity 69.9%). Multivariate Cox regression analysis indicated that the mortality rate was significantly higher in patients with high NLR level group (>5.6) (adjust hazard ratio=5.65, 95% CI 2.33-12.73, P<0.001). There was no potential heterogeneity in the further subgroup analysis across age (above vs. below 45 years old), sex, history of infections and pregnancy/postpartum, presence of coma and intracerebral hemorrhage. Conclusion: Elevated NLR value is associated with high risk of poor outcome in CVT patients.


e-CliniC ◽  
2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Lidia A. D. Dewanti ◽  
Agnes L. Panda ◽  
Victor F. F. Joseph ◽  
Monique Rotty

Abstract: Uncontrolled hypertension is the leading cause of the increased morbidity and mortality of congestive heart failure in developed countries. Moreover, diastolic dysfunction is the leading cause of heart failure in patients with hypertension. However, diagnosis as well as therapy of patients with hypertension and diastolic dysfunction is still a problem and the mechanism is still unclear, leading to the need of a parameter study as an initial predictor. In cardiovascular diseases, it is connected to the rise in neutrophil to lymphocyte ratio (NLR). This study was aimed to identify the relationship between NLR and the degree of diastolic dysfunction in patients with hypertension. This was an analytical and descriptive study with a cross sectional design. Variables included the NLR and the degree of diastolic dysfunction in patients with hypertension. The results obtained 31 patients, and highest percentages were males (24 patients; 77.42%), aged 61-65 years old (12 patients; 38.71%), and BMI scaling as overweight (17 patients; 54.83%). Most of the patients were categorized as normotension (12 patients; 38.71%). The majority of diastolic dysfunction degree was the 1st degree numbering 17 patients (54.84%). Minimum value of the NLR was 0.09 and the maximum was 19 with a standard deviation of 2.04. The Spearman’s parametric test showed a p-value of 0.315 and an r-value of 0.173 for the relationship between the NLR and the degree of diastolic dysfunction in patients with hypertension. In conclusion, there was no relationship between the NLR and degree of diastolic dysfunction in patients with hypertension.Keywords: neutrophil to lymphocyte ratio, diastolic dysfunction degree, hypertension Abstrak: Hipertensi yang tidak terkontrol merupakan penyebab utama meningkatnya morbiditas dan mortalitas gagal jantung kongesti di negara berkembang. Selain itu, disfungsi diastolik menjadi penyebab utama gagal jantung pada pasien hipertensi. Namun, penegakan diagnosis dan terapi pada pasien hipertensi dengan disfungsi diastolik masih menjadi masalah dan mekanismenya masih kurang dipahami sehingga diperlukan suatu parameter sebagai prediktor awal. Penyakit-penyakit kardiovaskular dikaitkan dengan peningkatan neutrophyl to lymphocyte ratio (NLR). Penelitian ini bertujuan untuk mengetahui hubungan NLR dengan derajat disfungsi diastolik pada pasien hipertensi. Jenis penelitian ialah deskriptif analitik dengan desain potong lintang. Variabel yang dianalisis ialah NLR dan derajat disfungsi diastolik pasien hipertensi. Hasil penelitian mendapatkan 31 sampel, dan persentase tertinggi ialah jenis kelamin laki-laki (24 pasien; 77,42%), usia pada rentang 61-65 (12 pasien; 38,71%), dengan IMT overweight (17 pasien; 54,83%). Kategori hipertensi terbanyak ialah kategori normal (12 pasien; 38,71%). Derajat disfungsi diastolik terbanyak ditemukan pada derajat 1 (17 pasien; 54,84%). Nilai minimum NLR 0,09 dan maksimum 10 dengan simpangan baku 2,04. Uji parametrik Spearman mendapatkan nilai p=0,315 dan r=0.173 untuk hubungan antara NLR dengan derajat disfungsi diastolik pada pasien hipertensi. Simpulan penelitian ini ialah tidak terdapat hubungan antara NLR dengan derajat disfungsi diastolik pada pasien hipertensi.Kata kunci: neutrophil to lymphocyte ratio, derajat disfungsi diastolik, hipertensi


2021 ◽  
Vol 10 (4) ◽  
pp. 791
Author(s):  
Sho Yasui ◽  
Tomoaki Takata ◽  
Yu Kamitani ◽  
Yukari Mae ◽  
Hiroki Kurumi ◽  
...  

Background: The indications for endoscopic submucosal dissection (ESD) for gastric cancer are based on preoperative histological assessment; however, examination of tissue biopsy is not always reliable as only a limited portion of the lesion can be obtained. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are markers of inflammatory response and are potentially associated with the grade of malignancy in gastric cancer. We aimed to investigate the association between NLR and PLR and the histology of gastric cancer. Methods: This study included 218 patients who underwent ESD for gastric cancer. The relationship between NLR/PLR and histological diagnosis was investigated. Results: Patients with adenocarcinomas showed significantly higher NLR and PLR than those with adenomas (p < 0.001 and p < 0.05, respectively). Further, patients with undifferentiated adenocarcinoma showed a significantly higher NLR (p < 0.05) than those with differentiated adenocarcinoma. Conclusion: This study suggests that NLR could be a useful marker for assessing early gastric cancer.


2021 ◽  
Vol 6 (1) ◽  
pp. 355
Author(s):  
Nurhasan Agung Prabowo ◽  
Arief Nurudhin

Penelitian ini bertujuan untuk mengetahui pengaruh ekstrak MO terhadap MVP dan NLR pada pasien autoimun. Metode penelitian yang digunakan adalah eksperimental yang dilakukan pada 30 pasien autoimun yang terdiri dari 28 pasien lupus dan 2 pasien rheumatoid arthritis di Poliklinik Reumatologi RSUD Moewardi pada Januari-Juli 2020. Pasien dikelompokkan menjadi dua, yaitu kelompok perlakuan dan kontrol. Pasien kelompok perlakuan mendapat 2gram ekstrak MO per hari, sedangkan pada kelompok kontrol mendapat plasebo. Perlakuan dilakukan selama 4 minggu, Pemeriksaan MPV dan NLR menggunakan haemositometer. Analisis statistik dilakukan dengan menggunakan uji-T berpasangan dan uji-T independen. Nilai p dianggap signifikan ketika p <0,05. Hasil penelitian menunjukkan bahwa MO menurunkan MPV (delta MPV = 4.141; r = 0.656; p = 0.02) dan NLR (delta NLR = 4.1391; r 0.489; p-value = 0.04). dapat disimpulkan MO menurunkan MPV dan NLR pada pasien autoimun.


Author(s):  
Filiz Güldaval ◽  
Ceyda Anar ◽  
Mine Gayaf ◽  
Gulru Polat ◽  
Merve Ayık Türk ◽  
...  

Objective: Various studies have reported that the neutrophil-to-lymphocyte ratio in the serum (sNLR) may serve as a cost-effective and useful prognostic factor in patients with various cancer types. We investigated the clinical impact of NLR as a prognostic factor in malign pleural effusion (MPE) and sNLR on prognosis in MPE. Method: We retrospectively reviewed all of the patients who were diagnosed MPE. The relationship between sNLR and neutrophil-to-lymphocyte ratio in the malign pleural effusion (mNLR) value, age, Eastern Cooperative Oncology Group (ECOG), histopathologic type, serum albumin and lactate dehydrogenase (LDH) with survival were investigated. Results: A total of 222 patients with a mean age of 65.7±11.5 were included in the study. Patients with a mNLR value ≥0.42 and a serum NLR value ≥4.75 had a shorter survival (p: 0.000). Multivariate analysis, which showed that survival was significantly related mNLR value > 0.42 and/or sNLR value > 4.75 (Odds Ratio (OR): 2.66, %95 CI, 1,65-4,3 p: 0.001), serum LDH > 210 (OR = 1.8, %95 CI, 1,33-2,46 p: 0.001) and age > 65 (OR = 1.9, %95 CI, 1,41-2,55 p = 0.001). Conclusion: sNLR and mNLR may act as a simple, useful, and cost-effective prognostic factor in patients with MPE. Furthermore, these results may serve as the cornerstone of further research into the mNLR in the future. Although further studies are required to generalize our results, this information will benefit clinicians and patients in determining the most appropriate therapy for patients with MPE.


2021 ◽  
Vol 10 (22) ◽  
pp. 5410
Author(s):  
Da Eun Ko ◽  
Hei Jin Yoon ◽  
Sang Beom Nam ◽  
Suk Won Song ◽  
Gisong Lee ◽  
...  

Objectives: To investigate if preoperative neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), or mean platelet volume (MPV) could be used to predict 1-year mortality in patients undergoing open abdominal aortic aneurysm (AAA) repair. Methods: We retrospectively reviewed 382 patients who underwent open AAA repair between January 2008 and July 2019. We divided the patients into two groups based on 1-year mortality and compared the preoperative NLR, PLR, and MPV. The patients were then classified into tertiles based on their preoperative NLR (first tertile: < 2.41 (n = 111); second tertile: 2.41 ≤ NLR ≤6.07 (n = 111); and third tertile: > 6.07 (n = 112)). We compared the incidence of mortality and morbidity across the aforementioned tertiles. We performed a stepwise logistic regression analysis to evaluate the predictors for mortality. An additional subgroup analysis was performed by dividing the cases into non-ruptured and ruptured cases. Results: The preoperative NLR was significantly higher in the non-survivor group than in the survivor group (10.53 ± 7.60 vs. 5.76 ± 6.44, respectively, p = 0.003). The PLR and MPV were similar between the groups (145.35 ± 91.11 vs. 154.20 ± 113.19, p = 0.626, 9.38 ± 1.20 vs. 9.11 ± 1.39, p = 0.267, respectively). The incidence of 1-year mortality was 2.7%, 9.0%, and 14.3% in the first, second, and third NLR tertiles, respectively (p = 0.009). Higher NLR (odds ratio 1.085, 95% confidence interval 1.016–1.159, p = 0.015) and ruptured AAA (odds ratio 2.706, 95% confidence interval 1.097–6.673, p = 0.031) were the independent predictors of 1-year mortality in all patients. Moreover, the preoperative NLR was significantly higher in the ruptured AAA than in the non-ruptured AAA group (11.17 ± 7.90 vs. 4.10 ± 4.75, p < 0.001). In subgroup analysis, preoperative NLR (odds ratio 1.144, 95% confidence interval 1.031–1.271, p = 0.012) and PLR (odds ratio 0.986, 95% confidence interval 16 0.975–0.998, p = 0.017) was an independent predictor for 1-year mortality in ruptured cases. Conclusions: We demonstrated an independent relationship between the preoperative NLR and 1-year mortality in patients undergoing open AAA repair, besides PLR and MPV. Furthermore, the NLR and PLR had predictive power for 1-year mortality in ruptured cases.


Sign in / Sign up

Export Citation Format

Share Document