title: The relationship between neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and thrombolysis in myocardial infarction risk score in patients with ST elevation acute myocardial infarction before primary coronary intervention.
abstract: BACKGROUND
  The thrombolysis in myocardial infarction (TIMI) risk score is calculated as the sum of independent predictors of mortality and ischemic events in ST elevation acute myocardial infarction (STEMI). Several studies show that the neutrophil to lymphocyte ratio (NLR) is a prognostic inflammatory marker. In preliminary studies, platelet to lymphocyte ratio (PLR) has been proposed as a pro-thrombotic marker. The relationship between NLR, PLR and TIMI risk score for STEMI has never been studied.
  
  
  OBJECTIVE
  To evaluate the association between TIMI-STEMI risk score and NLR, PLR and other biochemical indices in STEMI.
  
  
  METHODS
  In this retrospective study, we evaluated 390 patients who presented with STEMI within 12 h of symptom onset. Patients were grouped according to low and high TIMI risk scores.
  
  
  RESULTS
  We enrolled 390 patients (mean age 61.9 ±13.6 years; 73% were men). The NLR, platelet distribution width (PDW) and uric acid level (UA) were significantly associated with a high TIMI-STEMI risk score (p = 0.016, p = 0.008, p = 0.030, respectively), but PLR was not associated with a high TIMI-STEMI risk score. Left ventricular ejection fraction was an independent predictor of TIMI-STEMI risk score. A cut-off point of TIMI-STEMI score of > 4 predicted in-hospital mortality (sensitivity 75%, specificity 70%, p < 0.001). We found that NLR, PDW, and UA level were associated with TIMI-STEMI risk score.
  
  
  CONCLUSIONS
  Neutrophil to lymphocyte ratio, PDW and UA level are convenient, inexpensive and reproducible biomarkers for STEMI prognosis before primary angioplasty when these indicators are combined with the TIMI-STEMI risk score. We believe that these significant findings can guide further clinical practice.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Halit
authors.initials: H
authors.lastname: Acet
authors.affiliation: Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Faruk
authors.initials: F
authors.lastname: Ertaş
authors.affiliation: Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Mehmet Zihni
authors.initials: MZ
authors.lastname: Bilik
authors.affiliation: Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Mehmet Ata
authors.initials: MA
authors.lastname: Akıl
authors.affiliation: Department of Cardiology, Faculty of Medicine, İzmir University, İzmir, Turkey.
authors.forename: Ferhat
authors.initials: F
authors.lastname: Özyurtlu
authors.affiliation: Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Mesut
authors.initials: M
authors.lastname: Aydın
authors.affiliation: Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Oylumlu
authors.affiliation: Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Nihat
authors.initials: N
authors.lastname: Polat
authors.affiliation: Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Yüksel
authors.affiliation: Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Yıldız
authors.affiliation: Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Kaya
authors.affiliation: Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Akyüz
authors.affiliation: Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Hilal
authors.initials: H
authors.lastname: Ayçiçek
authors.affiliation: Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Özbek
authors.affiliation: Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Nizamettin
authors.initials: N
authors.lastname: Toprak
keywords: STEMI; TIMI risk score; hematologic indices; neutrophil to lymphocyte ratio; platelet to lymphocyte ratio