title: The relationship between neutrophil/lymphocyte ratio and infarct-related artery patency before mechanical reperfusion in patients with ST-elevation myocardial infarction.
abstract: OBJECTIVE
  Reduced baseline coronary flow in an infarct-related artery (IRA) before a primary percutaneous coronary intervention (PPCI) increases mortality in patients with ST-elevation myocardial infarction (STEMI). Increased neutrophil/lymphocyte (N/L) ratio has been linked to poor clinical outcomes in patients with STEMI. We investigated whether the N/L ratio, as measured at admission, was associated with IRA patency before mechanical reperfusion in patients with STEMI undergoing PPCI.
  
  
  METHODS
  A total of 404 patients who had undergone PPCI on a single culprit artery were enrolled in this study. According to thrombolysis in myocardial infarction (TIMI) flow grade in the IRA before PPCI, the study population was divided into two groups as TIMI 0 or 1 group (occluded IRA) and TIMI 2 or 3 group (patent IRA).
  
  
  RESULTS
  The N/L ratios were found to be significantly higher in the TIMI flow 0/1 group when compared with the TIMI flow 2/3 group (6.08±3.94 vs. 4.01±2.87, P=0.001). The absence of early IRA patency was associated with higher Syntax score, mean platelet volume, creatine kinase-myocardial band, and troponin T levels (P=0.0001, P=0.03, P<0.001, and P=0.004, respectively), and lower left ventricular ejection fraction (P=0.02). Multivariate logistic regression analysis showed that the N/L ratio and Syntax score were independent predictors of IRA patency (odds ratio: 1.89, 95% confidence interval: 1.82-1.98; odds ratio=2.80, 95% confidence interval: 1.75-3.86, respectively; P=0.001).
  
  
  CONCLUSIONS
  The N/L ratio has been found to be associated independently with early IRA patency before PPCI in patients who have undergone PCI for STEMI. This simple and cheap parameter can provide useful information on the related risk evaluation in these patients.
authors: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors: Alparslan
authors: A
authors: Kurtul
authors: Sani Namik
authors: SN
authors: Murat
authors: Mikail
authors: M
authors: Yarlioglues
authors: Mustafa
authors: M
authors: Duran
authors: Muhammed
authors: M
authors: Karadeniz
authors: Gokhan
authors: G
authors: Ergun
authors: Adil Hakan
authors: AH
authors: Ocek
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000503:physiopathology*; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D016015:Logistic Models; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood* / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D009504:Neutrophils; D016017:Odds Ratio; D018579:Patient Selection; D062645:Percutaneous Coronary Intervention; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D014654:Vascular Patency