title: Neutrophil-to-lymphocyte ratio (NLR) predicts mortality and adverse-outcomes after ST-segment elevation myocardial infarction in Chinese people.
abstract: Neutrophil-to-lymphocyte ratio (NLR) has been reported to predict cardiovascular risks and mortality in coronary artery diseases. We aimed to evaluate the capacity of NLR to predict long-term mortality in Chinese patients presenting with ST-segment elevation myocardial infarction (STEMI). We recorded NLR at admission, 24 or 72 hours after admission, and at discharge (14±2 days) of 692 patients presenting with STEMI at Xuanwu hospital, Beijing between 2002 and 2005, and assessed the capacity of NLR to predict mortality during follow up (median 9.43, interquartile range (IQR) 8.65-10.28 years). Backward stepwise multivariate Cox regression revealed that average inpatient NLR (NLRaverage) predicted all-cause mortality (Hazard ratio 1.481) more accurately than absolute leukocyte and neutrophil counts (P<0.001). When patients were stratified into tertiles by NLRaverage (T1 NLR<3.16, T3 NLR>4.75), patients in T3 exhibited a 4.621-fold higher risk of mortality than patients in T1 (P=0.002). Patients in T3 had a significantly higher incidence of all-cause mortality (10.00%) than T1 (2.17%) and T2 (4.31%), cardiac-mortality (8.70%) than T1 (2.17%) and T2 (4.31%), hypotension (20.00%) than T1 (5.65%) and T2 (12.93%), arrhythmia (43.91%) than T1 (24.14%) and T2 (24.35%), and defibrillation (7.83%) than T1 (1.74%) and T2 (5.17%) in hospital; and suffered from higher mortality (46.09%) than T1 (9.13%) and T2 (29.74%), cardiac mortality (27.83%) than T1 (5.22%) and T2 (15.52%) and MACE events (36.52%) than T1 (13.04%) and T2 (31.9%) during long-term follow-up. Average NLR was a useful and powerful predictor of mortality and adverse-outcomes in Chinese patients presenting with STEMI.
authors.affiliation: Department of Emergency, Xuanwu Hospital, Capital Medical University NO. 45, Changchun Street, Xicheng, Beijing 100053, China.
authors.forename: Jingyu
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Cardiology, Xuanwu Hospital, Capital Medical University NO. 45, Changchun Street, Xicheng, Beijing 100053, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Cardiology, Xuanwu Hospital, Capital Medical University NO. 45, Changchun Street, Xicheng, Beijing 100053, China.
authors.forename: Yunfei
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Xuanwu Hospital, Capital Medical University NO. 45, Changchun Street, Xicheng, Beijing 100053, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Hao
authors.affiliation: Department of Cardiology, Xuanwu Hospital, Capital Medical University NO. 45, Changchun Street, Xicheng, Beijing 100053, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Hua
mesh_terms: D000368:Aged; D019540:Area Under Curve; D044466:Asian People; D004569:Electroencephalography; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007958:Leukocyte Count; D008214:Lymphocytes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000276:immunology*; D009504:Neutrophils / Q000276:immunology*; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve
keywords: Myocardial infarction; biological markers; inflammation; leukocyte count; prognosis