title: Neutrophil to Lymphocyte Ratio Predicts Left Ventricular Remodeling in Patients with ST Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention.
abstract: OBJECTIVE
  It has been demonstrated that the neutrophil/lymphocyte ratio (NLR) might be a useful marker to predict cardiovascular risk and events. We aimed to investigate the role of the NLR to predict ventricular remodeling (VR) in patients with anterior ST-elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention.
  
  
  METHODS
  We prospectively included 274 consecutive anterior STEMI patients. Echocardiography was performed during admission and at six months after myocardial infarction. VR was defined as at least 20% increase from baseline in left ventricular end-diastolic volume. Patients were divided into two groups according to their VR status: VR (n=67) and non-VR (n=207). Total and differential leukocyte count, N-terminal pro-brain natriuretic peptide (NT-proBNP) and other biochemical markers were measured at admission and 24 hours later.
  
  
  RESULTS
  Compared with the non-VR group, peak creatine kinase MB (CK-MB), NT-proBNP (24 h), neutrophil/lymphocyte ratio, presence of diabetes, no-reflow frequency and wall motion score index were significantly higher in patients with VR (p<0.05 for all). On multivariate logistic regression analysis, NLR (β=2.000, 95% confidence interval=1.577-2.537, p<0.001) as well as peak CK-MB, NT-proBNP (24 h), WMSI and diabetes incidence were associated with VR. The cutoff value of the neutrophil/lymphocyte ratio obtained by receiver operator characteristic curve analysis was 4.25 for the prediction of VR (sensitivity: 79 %, specificity: 74%).
  
  
  CONCLUSIONS
  In patients with anterior STEMI, initial NLR and NT-proBNP measured 24 hours after admission may be useful for predicting adverse cardiovascular events including left VR.
authors.affiliation: Department of Cardiology, School of Medicine, Kafkas University, Kars, Turkey.
authors.forename: Abdurrezzak
authors.initials: A
authors.lastname: Börekçi
authors.affiliation: Department of Cardiology, School of Medicine, Kafkas University, Kars, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Gür
authors.affiliation: Department of Cardiology, Yenimahalle State Hospital, Ankara, Turkey.
authors.forename: Caner
authors.initials: C
authors.lastname: Türkoğlu
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Ahmet Oytun
authors.initials: AO
authors.lastname: Baykan
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Şeker
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Durmuş Yıldıray
authors.initials: DY
authors.lastname: Şahin
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Hazar
authors.initials: H
authors.lastname: Harbalıoğlu
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Elbasan
authors.affiliation: Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Topuz
authors.affiliation: Department of Cardiology, School of Medicine, Dicle University, Diyarbakır, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Çaylı
keywords: BNP; Myocardial infarction; Neutrophils, lymphocytes; No-reflow; Remodeling