title: Utility of Neutrophil-Lymphocyte Ratio in Predicting Troponin Elevation in the Emergency Department Setting.
abstract: There is little data regarding the diagnostic ability of neutrophil-lymphocyte ratio (NLR) in acute coronary syndrome. Therefore, we aimed to assess the predictive value of NLR in the discrimination of troponin-positive patients. We enrolled 244 patients (mean age 61.3 ± 11.7 years, 70.5% male) who presented to the emergency service with acute chest pain. Patients were divided into 2 groups based upon the troponin positivity in the 12- to 24-hour follow-up. The admission NLR was significantly higher in the troponin-positive group (5.49 ± 4.01 vs 2.40 ± 1.36, P < .001). A cutoff point of 2.80 for NLR measured on admission had 79% sensitivity and 73% specificity in predicting follow-up troponin positivity. After multivariate analysis, admission NLR and glucose levels remained significant predictors of follow-up troponin positivity. In conclusion, NLR may be an early diagnostic marker in emergency service for discriminating patients who will have a positive troponin test in the follow-up.
authors.affiliation: Department of Cardiology, Cankiri State Hospital, Cankiri, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Korkmaz
authors.affiliation: Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey drakadiryildiz@gmail.com.
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Yildiz
authors.affiliation: Department of Emergency Medicine, Cankiri State Hospital, Cankiri, Turkey.
authors.forename: Harun
authors.initials: H
authors.lastname: Gunes
authors.affiliation: Department of Cardiology, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Duyuler
authors.affiliation: Department of Cardiology, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Tuncez
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D014336:Troponin / Q000097:blood*
chemical_list: D015415:Biomarkers; D014336:Troponin
keywords: acute coronary syndrome; inflammation; neutrophil–lymphocyte ratio; troponin