title: Association of Neutrophil-to-lymphocyte Ratio with Contrast-induced Nephropathy in Patients with Non-ST-elevation Acute Coronary Syndrome Treated with Percutaneous Coronary Intervention.
abstract: BACKGROUND
  A higher neutrophil-to-lymphocyte ratio (NLR) is associated with poor clinical outcomes in various cardiovascular diseases, including acute coronary syndromes. However, the relationship between NLR and contrast-induced nephropathy (CIN) in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) undergoing percutaneous coronary intervention (PCI) has not been known. Hence, we investigated whether admission NLR is associated with CIN after PCI in patients with NSTE-ACS.
  
  
  METHODS
  A total of 478 patients (mean age 62.8±12.6 years, and 64.2% men), who were admitted to our hospital for NSTEACS and underwent PCI with stent, were recruited. Neutrophil-to-lymphocyte ratio was calculated via dividing neutrophil count by lymphocyte count. The patients were divided into two groups: CIN (+) and CIN (-). Contrast-induced nephropathy was defined as a ≥0.5mg/dL and/or a ≥25% increase in serum creatinine within 48-72hours post-PCI.
  
  
  RESULTS
  Admission NLR was significantly higher in patients with CIN than in patients without CIN (median 5.43, interquartile range 3.23-7.73 vs. median 2.59, interquartile range 1.83-3.88, P<0.001). On multivariate analysis, NLR ≥ 3.46 value (OR=2.631, 95%CI 1.146-6.060, P=0.022), estimated glomerular filtration rate (OR=0.963, P=0.004), high sensitivity C-reactive protein (OR=1.028, P=0.016) were independent factors of CIN.
  
  
  CONCLUSIONS
  Increased NLR is independently associated with risk of CIN in NSTE-ACS patients treated by PCI.
authors.affiliation: Ankara Education and Research Hospital, Department of Cardiology, Ankara, Turkey. Electronic address: alpkurtul@yahoo.com.
authors.forename: Alparslan
authors.initials: A
authors.lastname: Kurtul
authors.affiliation: Ankara Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Mikail
authors.initials: M
authors.lastname: Yarlioglues
authors.affiliation: Ankara Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Duran
authors.affiliation: Ankara Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Sani Namik
authors.initials: SN
authors.lastname: Murat
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000139:chemically induced / Q000503:physiopathology; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D062645:Percutaneous Coronary Intervention
chemical_list: D003287:Contrast Media; D003404:Creatinine
keywords: Contrast-induced nephropathy; Neutrophil-to-lymphocyte ratio; Non-ST-elevation acute coronary syndrome; Percutaneous coronary intervention