Predictive value of neutrophil-lymphocyte ratio to major adverse cardiovascular events in patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention
YANG Jin-long
LIU Huan
ZHOU Xue-feng
LUO Yong-quan
LIU Hong-bo
Abstract：Objective To investigate the predictive value of neutrophil-lymphocyte ratio (NLR) to major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI) within 7 d after percutaneous coronary intervention (PCI).Methods STEMI patients undergone PCI (n=136, male 71, female 65 and average age=64.58±11.72) were chosen from the Department of Cardiology of People’s Hospital of Leshan City from Jan. 2014 to Jan. 2016. All patients were divided, according to NLR level, into high-NLR group (>2.43,n=69) and low-NLR group (≤2.43,n=67). According to scores of global risk classification (GRC), the patients were divided into low-risk group (n=41), mid-risk group (n=67) and high-risk group (n=28). The materials including medical history, smoking history and family history were collected from the patients. The index of C-reactive protein (CRP) was detected after hospitalization, levels of white blood cell count (WBC), lymphocyte count and N-terminal pro-brain natriuretic peptide (NT-proBNP) were detected after PCI, and NLR level was calculated. The patients were observed for 7 d after PCI, and the occurrence of MACE was recorded. Results Compared with low-NLR group, the percentage of diabetic cases, levels of NT-proBNP, CRP, neutrophile granulocyte, NLR and MACE incidence increased, and lymphocytes decreased in high-NLR group (allP<0.05). NLR level was (1.52±0.48) in low-risk group, (2.41±0.52) in mid-risk group and (4.28±0.87) in high-risk group, and MACE incidence was 9.76% in low-risk group, 19.4% in mid-risk group and 53.57% in high-risk group. As GRC increased, MACE incidence and NLR level increased (allP<0.05). The results of receiver operating curve (ROC) analyzing on predictive values of NLR, GRC scores and GRC scores+NLR to MACE showed AUC was,respectively, 0.862 (95%CI: 0.791-0.974), 0.907 (95%CI: 0.855-0.967) and 0.938 (95%CI: 0.886~0.989). The results of multi-factor analysis showed that NLR (OR=2.794, 95%CI: 1.655~5.404), age (OR=1.451, 95%CI:1.602~1.842), NT-proBNP (OR=1.326, 95%CI: 1.063~1.814), diabetic history (OR=2.473, 95%CI: 1.571~3.679) and hypertensive history (OR=1.305, 95%CI: 1.041~3.816) were independent risk factors of MACE within 7 d after PCI in STEMI patients.Conclusion NLR, age, NT-proBNP, diabetic history and hypertensive history are independent risk factors of MACE within 7 d after PCI in STEMI patients. NLR combining GRC scores can effectively predict the incidence of MACE within 7 d after PCI in STEMI patients, which can assist refining the management of risk stratification in these patients.
Keywords：Neutrophil-lymphocyte ratioST-segment elevation myocardial infarctionMajor adverse cardiovascular events
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 1216-1219 )