title: Relationship between Neutrophil-to-Lymphocyte Ratio and Left Ventricular Free Wall Rupture in Acute Myocardial Infarction.
abstract: OBJECTIVE
  This study aimed to evaluate the relationship between the neutrophil-to-lymphocyte (N/L) ratio and left ventricular free wall rupture (LVFWR) in patients with ST elevation myocardial infarction (STEMI). Previous studies showed a correlation between increased levels of inflammatory markers and adverse cardiovascular events. The role of inflammation markers, particularly the N/L ratio, in mechanical complications after myocardial infarction has not been studied.
  
  
  METHODS
  Retrospectively, we compared the N/L ratio values of 23 patients with STEMI complicated by LVFWR with 214 STEMI patients without this complication. The diagnosis of rupture was confirmed by echocardiography in each case.
  
  
  RESULTS
  Neutrophil counts [median 8.5 × 103/µl, interquartile range (IQR) 6.4, vs. 7.8 × 103/µl, IQR 4.7, p = 0.02] and the N/L ratio (5.66, IQR 4.17, vs. 4.1, IQR 3.93, p = 0.01) were significantly higher in the LVFWR group. In receiver operating characteristic analysis, an N/L ratio above 3.7 predicted LVFWR with a sensitivity of 82.6% and a specificity of 46.9% (area under the curve = 0.654, p = 0.016). In multivariate regression analysis, age, hypertension, increased creatinine levels and increased N/L ratio (odds ratio = 1.61, 95% confidence interval = 1.15-2.23, p = 0.01) were found to be independent predictors of LVFWR.
  
  
  CONCLUSIONS
  In our study, the N/L ratio was found to be independently correlated with the risk of LVFWR. © 2015 S. Karger AG, Basel.
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiothoracic Surgery Center, Istanbul, Turkey.
authors.forename: Gokturk
authors.initials: G
authors.lastname: Ipek
authors.forename: Tolga
authors.initials: T
authors.lastname: Onuk
authors.forename: Mehmet Baran
authors.initials: MB
authors.lastname: Karatas
authors.forename: Barış
authors.initials: B
authors.lastname: Güngör
authors.forename: Isıl
authors.initials: I
authors.lastname: Atasoy
authors.forename: Ahmet
authors.initials: A
authors.lastname: Murat
authors.forename: Mustafa
authors.initials: M
authors.lastname: Aldag
authors.forename: Nizamettin Selcuk
authors.initials: NS
authors.lastname: Yelgec
authors.forename: Sennur Unal
authors.initials: SU
authors.lastname: Dayi
authors.forename: Osman
authors.initials: O
authors.lastname: Bolca