Frequency of High Neutrophil and Lymphocyte Ratio (NLR) Among NSTEMI/USA patients

2021 ◽  
Vol 15 (8) ◽  
pp. 2031-2034
Author(s):  
Afaq Shamim ◽  
Aijaz Zeeshan Khan Chachar ◽  
Miqdad Haider ◽  
Mohsin Asif ◽  
Sajjad Ali ◽  
...  

Background: Neutrophil to lymphocyte ratio (NLR) is comparatively a new prognostic marker used in patients with chronic stable angina (CSA). NLR can help in predicting short and long term moralities in NSTEMI patients. Aim: To evaluate the frequency of high neutrophil and lymphocyte ratio among NSTEMI/USA patients and to compare frequency of mortality in patients of NSTEMI/USA having high NLR with those without high NLR. Study design& duration: Descriptive, case series study from 25th November 2020 to 24th May 2021. Study settings: Department of Medicine and Cardiology, Fatima Memorial Hospital, Lahore. Methods: 185 patients having non ST elevation myocardial infarction (NSTEMI) and/or unstable angina (UA) having 30 to 70 years age and both males and females were included. Patients with sepsis having total Leucocyte count (TLC>11,000/<4000), history of surgery or on steroids in the past three months, history of hematological malignancy, late for fibrinolysis or those with contraindication to fibrinolysis were excluded were excluded. Demographic information (name, age, address, and education) was also noted. Results: Mean age of the participants was 57.99 ± 6.10 years while the age range was from 30 to 70 years. Most of patients 164 were included in the age group of 51 to 70 years. 110 (59.46%) patients were male and 75 (46.54%) of them were females. Frequency of neutrophil and lymphocyte ratio among NSTEMI/USA patients was found in 91 (49.19%) patients. My study has shown higher frequency of mortality in patients of NSTEMI/USA having high NLR 26 (28.57%) compared to normal NLR 06 (6.38%) with p value = 0.0001. Conclusion: Frequency of high neutrophil and lymphocyte ratio among NSTEMI/USA patients is very high with higher mortality in high Neutrophil-to-lymphocyte ratio group as compared to low NLR group. Keywords: Myocardial infarction, Non ST elevation, Neutrophil-to-lymphocyte ratio

Author(s):  
Sneha Barkur Sadashiva ◽  
KS Chenthil

Introduction: There have been various inflammatory markers implicated in the pathogenesis of Acute Coronary Syndromes (ACS). However, the role of the Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) as prognostic markers in ST-elevation Myocardial Infarction (STEMI) remains poorly researched. Aim: To determine the prognostic value of NLR and PLR to predict the immediate outcomes in patients with acute STEMI, and if any association exists between NLR/PLR and Thrombolysis in Myocardial Infarction (TIMI) risk score. Materials and Methods: This was a cross-sectional study conducted at a tertiary care centre, Puducherry, India, where 190 patients who presented to casualty with STEMI were enrolled. The patient co-morbidities, personal and family history were obtained. The routine laboratory parameters including platelets, lymphocytes, neutrophils and their corresponding ratios were calculated. Patients were grouped into low and high NLR/PLR groups and were assessed for occurrence of in-hospital mortality or Major Adverse Cardiovascular Events (MACE). Analysis was made to see if there is an association between NLR/PLR and MACE. Chi-square test and one-way ANOVA test was used for statistical significance. Results: Among 190 subjects, 157 male and 33 female with mean age of 55.72±11.24 years were included. A total of 8.94% patients 8.94% had MACE. NLR was positively associated with MACE (p-value=0.0006), whereas PLR was not associated with MACE. Patients with high NLR had 1.45 times higher odds of having MACE. NLR was significantly associated with TIMI risk score. Both NLR (F ratio=6.341) and PLR (F ratio=4.600) showed significant association with Killip classification, however NLR showed higher association (p-value <0.001). Conclusion: NLR can be used as a powerful prognostic marker for predicting immediate MACE and death in STEMI patients. In addition, NLR showed positive correlation with Killip classification and TIMI risk score.


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