title: Predictive value of elevated neutrophil-lymphocyte ratio for left ventricular systolic dysfunction in patients with non ST-elevated acute coronary syndrome.
abstract: OBJECTIVE
  We aimed to study the predictive value of the neutrophil-lymphocyte ratio (NLR) for left ventricular systolic dysfunction (LVSD) in patients with non ST-elevated acute coronary syndrome (NST-ACS).
  
  
  METHODS
  A total of 405 patients (mean age 62 years and 75% male) with NST-ACS were included in the study. The study population was divided into tertiles based on admission NLR values. The low, medium and high tertiles defined as NLR≤1.81 (n=135), 1.81<NLR≤3.2 (n=135) and NLR>3.2 (n=135), respectively.
  
  
  RESULTS
  The patients in the high NLR group were older (p<0.001), have higher rate of diabetes mellitus (p=0.028) and non-ST elevated myocardial infarction (NSTEMI) (p<0.001) and have lower left ventricular ejection fraction (LVEF) (p<0.001). Baseline WBC (p=0.02) and neutrophil (p<0.001) levels and NLR (p<0.001) were significantly higher, baseline hemoglobin (p=0.044), hematocrit (p=0.019) and lymphocyte (p<0.001) levels were significantly lower in the high NLR group. NLR was negatively correlated with LVEF in correlation analysis. An NLR >3.2 and age ≥70 were found to be an independent predictor of systolic dysfunction in multivariate analyses.
  
  
  CONCLUSIONS
  An NLR >3.2 is a useful predictor for LVSD in patients with NST-ACS. The practice of using an NLR count on admission may be useful for identifying high-risk patients and their associated treatment methods.
authors: Adem Bekler, MD, Department of Cardiology, Canakkale Onsekiz Mart University, School of Medicine, Canakkale/Turkey.
authors: Adem
authors: A
authors: Bekler
authors: Gokhan Erbag, MD, Department of Internal Medicine, Canakkale Onsekiz Mart University, School of Medicine, Canakkale/Turkey.
authors: Gokhan
authors: G
authors: Erbag
authors: Hacer Sen, MD, Department of Internal Medicine, Canakkale Onsekiz Mart University, School of Medicine, Canakkale/Turkey.
authors: Hacer
authors: H
authors: Sen
authors: Emine Gazi, MD, Department of Cardiology, Canakkale Onsekiz Mart University, School of Medicine, Canakkale/Turkey.
authors: Emine
authors: E
authors: Gazi
authors: Sedat Ozcan, MD, Department of Cardiovascular Surgery, Canakkale Onsekiz Mart University, School of Medicine, Canakkale/Turkey.
authors: Sedat
authors: S
authors: Ozcan
keywords: Acute coronary syndrome; Ejection fraction; Myocardial infarction; Neutrophil-lymphocyte ratio; Systolic dysfunction