Relation Between Neutrophil-to-Lymphocyte Ratio and Index of Microcirculatory Resistance in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.
The neutrophil-to-lymphocyte ratio (NLR) has been proved as a reliable inflammatory marker for the atherosclerotic process and as a predictor for clinical outcomes in patients with various cardiovascular diseases. A recent study reported that elevated NLR is associated with impaired myocardial perfusion in patients with ST-segment elevation myocardial infarction (STEMI). We investigated whether NLR is associated with coronary microcirculation as assessed by the index of microcirculatory resistance (IMR) in patients with STEMI who had undergone primary percutaneous coronary intervention (PCI). A total of 123 patients with STEMI who underwent successful primary PCI were enrolled in this study. NLR was obtained on admission, and patients were divided into 3 groups by NLR tertile. IMR was measured using an intracoronary thermodilution-derived method immediately after index PCI. Symptom onset-to-balloon time was significantly longer (p = 0.005), and IMR was significantly higher in the high NLR group than that in the low and intermediate groups (21.94 ± 12.87 vs 23.22 ± 12.73 vs 32.95 ± 20.60, p = 0.003). Furthermore, in multiple linear regression analysis, NLR showed an independent positive correlation with IMR (r = 0.205, p = 0.009). In conclusion, NLR has shown positive correlation with IMR, whereas negative association with infarct-related artery patency in patients with STEMI who underwent primary PCI. Therefore, NLR at admission could reflect myocardial damage and the status of coronary microcirculation in patients with STEMI (ClinicalTrials.gov number, NCT02828137).
Department of Cardiology, Inha University Hospital, Incheon, Republic of Korea.
Man-Jong
MJ
Lee
Department of Cardiology, Inha University Hospital, Incheon, Republic of Korea.
Sang-Don
SD
Park
Department of Cardiology, Inha University Hospital, Incheon, Republic of Korea. Electronic address: kwonswdr@gmail.com.
Sung Woo
SW
Kwon
Department of Cardiology, Inha University Hospital, Incheon, Republic of Korea. Electronic address: siwoo@inha.ac.kr.
Seong-Ill
SI
Woo
Department of Cardiology, Inha University Hospital, Incheon, Republic of Korea.
Myung-Dong
MD
Lee
Department of Cardiology, Inha University Hospital, Incheon, Republic of Korea.
Sung-Hee
SH
Shin
Department of Cardiology, Inha University Hospital, Incheon, Republic of Korea.
Dae-Hyeok
DH
Kim
Department of Cardiology, Inha University Hospital, Incheon, Republic of Korea.
Jun
J
Kwan
Department of Cardiology, Inha University Hospital, Incheon, Republic of Korea.
Keum-Soo
KS
Park
D017023:Coronary Angiography; D003326:Coronary Circulation; D005260:Female; D006801:Humans; D008214:Lymphocytes; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009504:Neutrophils; D062645:Percutaneous Coronary Intervention; D012189:Retrospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000097:blood* / Q000503:physiopathology* / Q000628:therapy*; D013815:Thermodilution; D016896:Treatment Outcome; D014655:Vascular Resistance