title: Neutrophil-to-lymphocyte ratio predicts response to cardiac resynchronization therapy.
abstract: BACKGROUND
  Neutrophil-to-lymphocyte (N/L) ratio has been associated with adverse outcomes in patients with acute coronary syndromes and increased risk for long-term mortality in patients with acute decompensated heart failure. We aimed to investigate the prognostic value of neutrophil-to-lymphocyte ratio on response to cardiac resynchronization therapy (CRT).
  
  
  METHODS
  Seventy consecutive patients (mean age 58 ± 13 years; 40 men) undergoing CRT were included in the study. Hematological and echocardiographic parameters were measured before and 6 months after CRT. Echocardiographic response to CRT was defined as a ≥ 15% reduction in left ventricular end-systolic volume at 6-month follow-up.
  
  
  RESULTS
  After 6 months of CRT, 49 (70%) patients were responders. After 6 months, left ventricular ejection fraction (LVEF) had significantly increased, from 21 ± 7% to 34 ± 11% in responder patients (p = 0.001). N/L ratio decreased significantly, from 2.4 ± 1 to 2.1 ± 0.7 in responders (p = 0.04). In multivariate analysis, significant associates of echocardiographic response to CRT was evaluated adjusting for age, etiology of cardiomyopathy, baseline LVEF, New York Heart Association functional class, C-reactive protein, and baseline N/L ratio. Baseline N/L ratio was the only predictor of response to CRT (OR 1.506, 95% CI, 1.011-2.243, p = 0.035).
  
  
  CONCLUSIONS
  N/L ratio at baseline could help to identify patients with response to CRT.
authors.affiliation: Department of Cardiology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
authors.forename: Aysen
authors.initials: A
authors.lastname: Agacdiken
authors.forename: Umut
authors.initials: U
authors.lastname: Celikyurt
authors.forename: Tayfun
authors.initials: T
authors.lastname: Sahin
authors.forename: Kurtulus
authors.initials: K
authors.lastname: Karauzum
authors.forename: Ahmet
authors.initials: A
authors.lastname: Vural
authors.forename: Dilek
authors.initials: D
authors.lastname: Ural
mesh_terms: D058406:Cardiac Resynchronization Therapy; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology*; D016896:Treatment Outcome