CLINICAL IMMUNOLOGY
Neutrophil to lymphocyte ratio is associated with proximal/middle segment of the LAD lesions in patients with ST segment elevation infarction
 
More details
Hide details
 
Submission date: 2015-08-27
 
 
Final revision date: 2015-11-03
 
 
Acceptance date: 2015-11-23
 
 
Publication date: 2017-01-24
 
 
Cent Eur J Immunol 2016;41(4):386-391
 
KEYWORDS
ABSTRACT
Introduction: Neutrophil to lymphocyte ratio (NLR) was revaled to have a close relation with atherosclerotic cardiovascular disease. The relationship between NLR and culprit plaque localization has never been studied.
Aim of the study: To evaluate the association between NLR and unstable plaque localization of left anterior descending artery (LAD) in anterior miyocardial infarction patients.
Material and methods: Patients admitted to our hospital with acute anterior STEMI were included. Fifhy-eight patients who have single-vessel disease at LAD and their hematological parameters were analyzed retrospectively. Proximal segment of LAD lesions were groupped as Group I and mid segment of the LAD lesion groupped as Group II. The groups were compared according to their NLR and other parameters.
Results: Between group I (n = 41, mean age 52.5 ±12.7) and group II (n = 17, mean ages 52.0 ±10.8); NLR, were significantly higher in group I compared to the group II (6.9 ±5.6 vs. 3.3 ±2.0, p = 0.01). In group I, left ventricular ejection fraction (LVEF) was significantly lower (p = 0.02). In correlation analyzes, NLR was positively correlated with CK MB (r = 0.32, p = 0.01) and negatively correlated with LVEF (r = –0.28, p = 0.03).
Conclusions: The present study demonstrated that anterior myocardial infarction patients with high NLR had a greater possibility having proximal culprit lesion on the LAD. Therefore NLR can be used as a useful tool to culprit plaque localization in patients with acute miyocardial infarction patients.
REFERENCES (32)
1.
Crouse JR 3rd, Grobbee DE, O’Leary DH, et al. (2004): Measuring Effects on intima media Thickness: an Evaluation Of Rosuvastatin in subclinical atherosclerosis – the rationale and methodology of the METEOR study. Cardiovasc Drugs Ther 18: 231-238.
 
2.
Rauch U, Osende JI, Fuster V, et al. (2001): Thrombus formation on atherosclerotic plaques: pathogenesis and clinical consequences. Ann Intern Med 134: 224-238.
 
3.
Tamhane UU, Aneja S, Montgomery D, et al. (2008): Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 102: 653-657.
 
4.
Núñez J, Núñez E, Bodí V, et al. (2008): Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction. Am J Cardiol 101: 747-752.
 
5.
Hansson GK (2005): Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med 352: 1685-1695.
 
6.
Weissberg PL (2000): Atherogenesis: current understanding of the causes of atheroma. Heart 83: 247-252.
 
7.
Horne BD, Anderson JL, John JM, et al. (2005): Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol 45: 1638-1643.
 
8.
Duffy BK, Gurm HS, Rajagopal V, et al. (2006): Usefulness of an elevated neutrophil to lymphocyte ratio in predicting long-term mortality after percutaneous coronary intervention. Am J Cardiol 97: 993-996.
 
9.
Núñez J, Núñez E, Bodí V, et al. Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction. Am J Cardiol 2008; 101: 747-752.
 
10.
Muhammed Suliman MA, Bahnacy Juma AA, Ali Almadhani AA, et al. (2010): Predictive value of neutrophil to lympho­cyte ratio in outcomes of patients with acute coronary syndrome. Arch Med Res 41: 618-622.
 
11.
Cho KH, Jeong MH, Ahmed K, et al. (2011): Value of early risk stratification using hemoglobin level and neutrophil-to-lymphocyte ratio in patients with ST-elevation myocardial infarction undergoing primary percuta­neous coronary intervention. Am J Cardiol 107: 849-856.
 
12.
Arbel Y, Finkelstein A, Halkin A, et al. (2012): Neutrophil/lymphocyte ratio is re­lated to the severity of coronary artery disease and clinical outcome in patients undergoing angiography. Atherosclerosis 225: 456-460.
 
13.
Park JJ, Jang HJ, Oh IY, et al. (2013): Prognostic value of neutrophil to lymphocyte ratio in pa­tients presenting with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Am J Cardiol 111: 636-642.
 
14.
Yilmaz M, Tenekecioglu E, Arslan B, et al. (2015): White blood cell subtypes and neutrophil-lymphocyte ratio in prediction of coronary thrombus formation in non-ST-segment elevated acute coronary syndrome. Clin Appl Thromb Hemost 21: 446-452.
 
15.
Acet H, Ertaş F, Bilik MZ, et al. (2015): The relationship between neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and thrombolysis in myocardial infarction risk score in patients with ST elevation acute myocardial infarction before primary coronary intervention. Postep Kardiol Inter 11: 126-135.
 
16.
Thygesen K, Alpert JS, Jaffe AS, et al. (2012): Third universal definition of myocardial infarction. J Am Coll Cardiol.
 
17.
60: 1581-1598.
 
18.
Lang RM, Bierig M, Devereux RB, et al. (2005): Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiography 12: 1440-1463.
 
19.
Valencia J, Borders P, Berenguer A, et al. (2002): Long term follow-up of patients with proximal left anterior descending coronary artery stenosis treated with stent. Rev Esp Cardiol 55: 607-615.
 
20.
Carrizo S, Peinado RP, Sanchez-Recalde A, et al. (2015): Clinical and angiographic characteristics of patients with acute coronary syndrome associated with sudden cardiac death. Hellenic J Cardiol 56: 136-141.
 
21.
Califf RM, Tomabechi Y, Lee KL, et al. (1983): Outcome in one-vessel coronary artery disease. Circulation 67: 283-290.
 
22.
Klein LW, Weintraub WS, Agarwal JB, et al. (1986): Prognostic significance of severe narrowing of the proximal portion of the left anterior descending coronary artery. Am.
 
23.
J Cardiol 58: 42-46.
 
24.
Arnar DO, Bullinga JR, Martins JB (1997): Role of the Purkinje system in spontaneous ventricular tachycardia during acute ischemia in a canine model. Circulation 96: 2421-2429.
 
25.
Kwofie MA, Chaudhary AK, Martins JB (2011): Association among intracardiac T-wave alternans, ischemia, and spontaneous ventricular arrhythmias after coronary artery occlusion in a canine model. Transl Res 158: 265-272.
 
26.
Colaco R, Reay P, Beckett C, et al. (2000): False positive ECG reports of anterior myocardial infarction in women. J Electrocardiol 33: 239-24.
 
27.
Figueras J (2002): Non precordial leads and the level of coronary obstruction in acute anterior myocardial infarction: something clinically useful or only redundant information? Rev Esp Cardiol 55: 1015-1017.
 
28.
Imtiaz F, Shafique K, Mirza SS, et al. (2012): Neutrophil lym­phocyte ratio as a measure of systemic inflammation in prevalent chron­ic diseases in Asian population. Int Arch Med 5: 1-6.
 
29.
Choi YH, Hong YJ, Ahn Y, et al. (2014): Relationship between Neutrophil-to-Lymphocyte Ratio and Plaque Components in Patients with Coronary Artery Disease: Virtual Histology Intravascular Ultrasound Analysis. J Korean Med Sci 29: 950-956.
 
30.
Gibson CM, Kirtane AJ, Murphy SA, et al. (2003): Distance from the coronary ostium to the culprit lesion in acute ST-elevation myocardial infarction and its implications regarding the potential prevention of proximal plaque rupture. J Thromb Thrombolysis 15: 189-196.
 
31.
Wang JC, Normand SL, Mauri L, et al. (2004): Coronary artery spatial distribution of acute myocardial infarction occlusions. Circulation 110: 278-284.
 
32.
Fowler AJ, Agha RA (2013): Neutrophil/lymphocyte ratio is related to the sever­ity of coronary artery disease and clinical outcome in patients undergo­ing angiography: the growing versatility of NLR. Atherosclerosis 228: 44-45.
 
eISSN:1644-4124
ISSN:1426-3912
Journals System - logo
Scroll to top