title: Increased neutrophil-to-lymphocyte ratio predicts persistent coronary no-flow after wire insertion in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention.
abstract: OBJECTIVE
  Acute ST-segment elevation myocardial infarction patients presenting persistent no-flow after wire insertion have a lower survival rate despite successful mechanical intervention. The neutrophil-to-lymphocyte ratio has been associated with increased mortality and worse clinical outcomes in ST-segment elevation myocardial infarction. We hypothesized that an elevated neutrophil-to-lymphocyte ratio would also be associated with a persistent Thrombolysis In Myocardial Infarction flow grade of 0 after wire insertion in patients undergoing primary percutaneous coronary intervention.
  
  
  METHODS
  A total of 644 patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention within 12 hours of symptom onset were included in our study. Blood samples were drawn immediately upon hospital admission. The patients were divided into 3 groups according to their Thrombolysis In Myocardial Infarction flow grade: Thrombolysis In Myocardial Infarction flow grade 0 after wire insertion, Thrombolysis In Myocardial Infarction flow grade 1-3 after wire insertion and Thrombolysis In Myocardial Infarction flow grade 1-3 at baseline.
  
  
  RESULTS
  The neutrophil-to-lymphocyte ratio was significantly higher in the group with Thrombolysis In Myocardial Infarction flow grade 0 after wire insertion compared with the group with Thrombolysis In Myocardial Infarction flow grade 1-3 after wire insertion and the group with Thrombolysis In Myocardial Infarction flow grade 1-3 at baseline. The group with Thrombolysis In Myocardial Infarction flow grade 0 after wire insertion also had a significantly higher in-hospital mortality rate. Persistent coronary no-flow after wire insertion was independently associated with the neutrophil-to-lymphocyte ratio.
  
  
  CONCLUSIONS
  An increased neutrophil-to-lymphocyte ratio on admission is significantly associated with persistent coronary no-flow after wire insertion in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
authors: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors: Alparslan
authors: A
authors: Kurtul
authors: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors: Sani Namik
authors: SN
authors: Murat
authors: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors: Mikail
authors: M
authors: Yarlioglues
authors: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors: Mustafa
authors: M
authors: Duran
authors: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors: Ibrahim Etem
authors: IE
authors: Celik
authors: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors: Alparslan
authors: A
authors: Kilic
authors: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors: Adil Hakan
authors: AH
authors: Ocek
mesh_terms: D000368:Aged; D015415:Biomarkers; D003326:Coronary Circulation / Q000502:physiology; D004812:Epidemiologic Methods; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000601:surgery*; D009504:Neutrophils; D054318:No-Reflow Phenomenon / Q000097:blood* / Q000175:diagnosis; D062645:Percutaneous Coronary Intervention / Q000379:methods* / Q000401:mortality; D011379:Prognosis; D012016:Reference Values; D015912:Thrombolytic Therapy / Q000379:methods* / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers