title: Neutrophil to lymphocyte ratio in acute ST-segment elevation myocardial infarction.
abstract: BACKGROUND
  Spontaneous early patency of infarct-related artery (IRA) on arrival for primary percutaneous coronary intervention is associated with better short- and long-term prognosis in patients with ST-segment elevation myocardial infarction (STEMI). We aimed to investigate whether the hemographic parameters on admission are associated with spontaneous IRA patency.
  
  
  METHODS
  This was a retrospective study of 1,625 patients with acute STEMI who underwent primary percutaneous coronary intervention<12 hours after the onset of symptoms.
  
  
  RESULTS
  Angiography showed patent IRA (prethrombolysis in myocardial infarction [TIMI] grade 3 flow) in 160 (9.8%) patients. Neutrophil count on admission (7.8±2.4×10³/μL versus 9.7±3.8×10³/μL; P<0.001) was significantly lower and lymphocyte count (2.4±1.0×10³/μL versus 1.9±1.1×10³/μL; P<0.001) on admission was significantly higher in the patent IRA group. Neutrophil to lymphocyte ratio (NLR) was significantly lower in the patent IRA group (4.1±3.2 versus 6.9±5.5; P<0.001). Admission leukocyte counts (13±4.0×10³/μL versus 12±3.4×10³/μL; P<0.001) and NLR (7.2±5.8 versus 5.5±4.4; P<0.001) of the patients with TIMI thrombus score≥4 were significantly higher than patients with TIMI thrombus score<4. In the multivariate analysis, NLR≥4.5 (3.17 [95% confidence interval: 2.04-4.92]; P<0.001) was found to be independently predicting an occluded IRA on initial angiography with a sensitivity of 62.7% and a specificity of 70%.
  
  
  CONCLUSIONS
  NLR on admission is significantly related to angiographic thrombus burden and spontaneous early IRA patency in patients with acute STEMI.
authors.affiliation: Department of Cardiology (AE, BT), Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey; Department of Cardiology (VO), Fatih Medical Park Hospital, Istanbul, Turkey; and Department of Cardiology (AK, CYK, TA, AG, SP, CK), Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey.
authors.forename: Ayhan
authors.initials: A
authors.lastname: Erkol
authors.forename: Vecih
authors.initials: V
authors.lastname: Oduncu
authors.forename: Burak
authors.initials: B
authors.lastname: Turan
authors.forename: Alev
authors.initials: A
authors.lastname: Kiliçgedik
authors.forename: Can Yücel
authors.initials: CY
authors.lastname: Karabay
authors.forename: Taylan
authors.initials: T
authors.lastname: Akgün
authors.forename: Ahmet
authors.initials: A
authors.lastname: Güler
authors.forename: Selçuk
authors.initials: S
authors.lastname: Pala
authors.forename: Cevat
authors.initials: C
authors.lastname: Kirma
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D018655:Lymphocyte Count / Q000379:methods; D008214:Lymphocytes / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis*; D009504:Neutrophils / Q000378:metabolism*; D012189:Retrospective Studies; D016037:Single-Blind Method