title: Prognostic Value of Neutrophil-to-Lymphocyte Ratio for Patients Undergoing Heart Valve Replacement.
abstract: The neutrophil-tolymphocyte ratio (NLR) was found to be a predictor of adverse outcome in patients with coronary artery disease (CAD). The ratio may also be a useful marker to predict mortality following valve replacement surgery.
  
  
  
  A total of 932 patients was enrolled retrospectively. Patients were allocated to three tertiles based on their NLR (group 1, NLR ≤1.90; group 2, 1.90 < NLR ≤2.93; group 3, NLR >2.93).
  
  
  
  Patients in the highest tertile were older (p = 0.049, 95% CI 0.09-5.98), tended to have chronic renal failure (p = 0.028, OR: 2.6, 95% CI 1.08-6.35), and had more frequent critical CAD on preoperative angiography (p <0.001, OR 2.1, 95% CI 1.38-3.21). Postoperatively, patients in the highest NLR tertile had a higher in-hospital mortality rate than those in the first tertile (p <0.001, OR 4.67, 95% CI 2.37-9.20) and second tertile (p = 0.002, OR 2.26, 95% CI 1.32-3.86). Patients in the third tertile had the highest mortality at day 300 (log-rank p <0.001). The hazard ratio (HR) for the second tertile was 1.8 (p = 0.11, 95% CI 0.88-3.79), and for the third tertile was 2.8 (p = 0.003, 95% CI 1.40-5.59).
  
  
  
  The NLR is a useful parameter to assess postoperative in-hospital mortality risk after valvular surgery.
authors.affiliation: Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Sinan Guvenc
authors.affiliation: Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey. Electronic correspondence: ahmetekmekci@yahoo.com.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ekmekci
authors.affiliation: Clinic of Cardiology, Yedikule Thoracic Disease and Surgery Center Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Uluganyan
authors.affiliation: Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Ertas
authors.affiliation: Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
authors.forename: Hatice
authors.initials: H
authors.lastname: Betul Erer
authors.affiliation: Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Ozpamuk Karadeniz
authors.affiliation: Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ozan
authors.initials: O
authors.lastname: Tanik
authors.affiliation: Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Oz
authors.affiliation: Clinic of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
authors.forename: Cevdet
authors.initials: C
authors.lastname: Kocogullari
authors.affiliation: Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
authors.forename: Yalcin
authors.initials: Y
authors.lastname: Velibey
authors.affiliation: Clinic of Cardiology, Osmancik Government Hospital, Corum, Turkey.
authors.forename: Gurkan
authors.initials: G
authors.lastname: Karaca
authors.affiliation: Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Eren
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D006349:Heart Valve Diseases / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D016017:Odds Ratio; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome