title: The relationship of coronary flow to neutrophil/lymphocyte ratio in patients undergoing primary percutaneous coronary intervention.
abstract: OBJECTIVE
  It has been known that inflammatory mechanisms play an important role in the coronary artery disease. Our aim in this study was to investigate the relationship between the neutrophil/lymphocyte (N/L) ratio and coronary flow velocity after primary percutaneous coronary intervention (PCI) in patients presenting with ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  Two hundred and ten patients who had undergone primary PCI were included. The coronary flow velocities were evaluated using the recorded PCI procedures by Thrombolysis in Myocardial Infarction (TIMI) flow grades and corrected TIMI frame counts (cTFC) values. A value of >40 for the final cTFC was accepted as an index of insufficient coronary blood flow. The white blood cell subtypes and counts were determined in the blood samples obtained at the clinics.
  
  
  RESULTS
  In 165 (78%) of the investigated patients, reperfusion was found to be sufficient (Group I) while in 45 (22%) of them (Group II) insufficient reperfusion was observed (Group II). In-hospital mortality was 7.2% (n=12) in Group I, whereas it was 17.7% (n=8) in Group II (P=0.033). Similarly, one-year mortality was higher in Group II (26.6%, n=12) than in Group I (13.3%, n=22) (P=0.031). N/L ratio was determined to be higher in Group I than in Group II (8.3±6.1 vs. 6.2±5.0; P=0.034). Also, N/L ratio was found as an independent predictor of severe no-reflow development (TIMI 0-1) and of one-year mortality (P=0.01 and P=0.047, respectively).
  
  
  CONCLUSIONS
  N/L ratio has been found to be an independent indicator for no-reflow development in patients who have undergone PCI for acute STEMI. This simple and low-cost parameter can provide useful information for the relevant risk evaluation in these patients.
authors.affiliation: Department of Cardiology, Ondokuz Mayis University, Faculty of Medicine, Samsun, Turkey.
authors.forename: Korhan
authors.initials: K
authors.lastname: Soylu
authors.forename: Serkan
authors.initials: S
authors.lastname: Yuksel
authors.forename: Okan
authors.initials: O
authors.lastname: Gulel
authors.forename: Ali Riza
authors.initials: AR
authors.lastname: Erbay
authors.forename: Murat
authors.initials: M
authors.lastname: Meric
authors.forename: Halit
authors.initials: H
authors.lastname: Zengin
authors.forename: Muhtar
authors.initials: M
authors.lastname: Museyibov
authors.forename: Erdogan
authors.initials: E
authors.lastname: Yasar
authors.forename: Sabri
authors.initials: S
authors.lastname: Demircan
keywords: Inflammation; acute ST-segment elevation myocardial infarction (acute STEMI); neutrophil/lymphocyte ratio (N/L ratio)