title: Association of neutrophil/lymphocyte ratio with long-term mortality after ST elevation myocardial infarction treated with primary percutaneous coronary intervention.
abstract: BACKGROUND
  Primary percutaneous coronary interventions (PCI) have been proposed as a novel superior management strategy in patients with ST elevation myocardial infarction (STEMI). This study tested the hypothesis that in the acute phase of myocardial infarction with ST-segment elevation, the neutrophil/lymphocyte (N/L) ratio is a predictor of long-term prognosis.
  
  
  METHODS
  We analyzed 551 consecutive STEMI patients treated with primary PCI at a single university center. Patients were stratified according to quartiles of the mean neutrophil/lymphocyte ratio.
  
  
  RESULTS
  Kaplan-Meier survival analysis showed a cumulative eight-year survival of 94.2% in the first quartile, 92.0% in the second quartile, 91.3% in the third quartile, and 75.4% in the fourth quartile (P < 0.001 by log rank). Relative to patients in the other three lower N/L ratio quartiles, patients in the highest quartile were more than four times more likely to die during hospitalization (P < 0.001) and during long-term follow-up (P < 0.001). By multivariate Cox regression analysis including baseline demographic, clinical, and angiographic covariables, the N/L ratio in the highest quartile remained an independent predictor of mortality (hazard ratio 2.38, 95% confidence interval (CI) 1.42 to 3.98; P = 0.001).
  
  
  CONCLUSIONS
  The neutrophil/lymphocyte ratio is a strong independent predictor of long-term mortality after ST elevation myocardial infarction treated with very early revascularization.
authors.affiliation: Department of Cardiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China.
authors.forename: Xu-Hua
authors.initials: XH
authors.lastname: Shen
authors.forename: Qi
authors.initials: Q
authors.lastname: Chen
authors.forename: Yan
authors.initials: Y
authors.lastname: Shi
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D018791:CD4 Lymphocyte Count; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000276:immunology / Q000401:mortality* / Q000628:therapy*; D009504:Neutrophils / Q000502:physiology*; D011379:Prognosis; D016016:Proportional Hazards Models