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Predictive value of neutrophil to lymphocyte ratio in long‐term outcomes of left main and/or three‐vessel disease in patients with acute myocardial infarction
Author(s) -
Xu Na,
Tang XiaoFang,
Yao Yi,
Zhao Xueyan,
Chen Jue,
Gao Zhan,
Yang Yuejin,
Gao RunLin,
Xu Bo,
Yuan JinQing
Publication year - 2018
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27495
Subject(s) - medicine , neutrophil to lymphocyte ratio , hazard ratio , conventional pci , percutaneous coronary intervention , myocardial infarction , cardiology , confidence interval , acute coronary syndrome , lymphocyte
Objectives We sought to evaluate the independent predictive value of left main disease (LMD) and/or three‐vessel disease (LMD/3VD) in acute myocardial infarction (AMI) patients. Background Patients with acute coronary syndrome resulting from LMD and/or three‐vessel disease (LMD/3VD) are at the highest risk of adverse cardiovascular events. Neutrophil to lymphocyte ratio (NLR) has been proposed as a marker of cardiovascular risk, but the prognostic value of NLR in patients with LMD/3VD who underwent percutaneous coronary intervention (PCI) is not clearly defined. Methods Patients ( n = 806) admitted with LMD/3VD who underwent PCI between January 2013 and December 2013 were followed up for 2 years. Admission NLR was divided into two sub‐groups based on an optimal cut off value predicting 2‐year all‐cause mortality. The primary end point was all‐cause death. The secondary end point was long‐term major adverse cardiovascular and cerebrovascular events (MACCE). Results During follow‐up, the high NLR group was associated with a significantly higher rate of long‐term all‐cause mortality (6.7 vs. 0.9%, P < .001), and MACCE (24.7 vs. 15.8%, P = .002) compared to the low NLR group. In multivariate analysis, after adjusting for risk factors, NLR ≥ 3.39 was determined to be an independent predictor of 2‐year all‐cause mortality (hazard ratio[HR] 3.08, 95% confidence interval [CI] 1.06 to 8.97, P = .039) and MACCE (hazard ratio 1.44, 95% CI 1.01 to 2.05, P = .046) for LMD/3VD. Conclusions The admission NLR as relatively inexpensive marker of inflammation may aid in the risk stratification and prognosis of patients diagnosed with LMD/3VD.