Neutrophil to Lymphocyte Ratio Is Related to Electrocardiographic Sign of Spontaneous Reperfusion in Patients with ST-segment Elevation Myocardial Infarction

Arch Med Res. 2016 Apr;47(3):180-5. doi: 10.1016/j.arcmed.2016.06.002. Epub 2016 Jun 24.

Abstract

Background and aims: ST-segment resolution ≥70% on consecutive electrocardiograms (ECGs) before administration of definitive reperfusion therapy is considered as an electrocardiographic sign of spontaneous reperfusion (SR) in STEMI patients and it indicates not only the patency of the infarct-related artery (IRA) but also the microvascular and myocardial reperfusion. Neutrophil/lymphocyte (N/L) ratio has been demonstrated to be associated with the patency of the IRA and no-reflow in patients with STEMI before mechanical reperfusion therapy. However, the association between N/L ratio and ST-segment resolution in STEMI patients with SR was not investigated. The aim of this study was to focus on the relation between N/L ratio and ST-segment resolution in STEMI patients with SR.

Methods: One hundred sixty two consecutive patients with their first diagnosed STEMI were enrolled in this study. ECGs of all the patients at admission and 1 h later were obtained. According to electrocardiographic sign of SR, the patients were divided into two groups as SR group and non-SR group. Clinical data between two groups were evaluated.

Results: Patients in SR group had lower neutrophil counts, higher lymphocyte counts, and lower N/L ratio than patients in non-SR group. Moreover, after undertaking primary PCI, patients in SR group had lower peak cTnT value and higher LVEF than patients in non-SR group. Furthermore, N/L ratio was an independent predictor of electrocardiographic sign of SR in patients with STEMI.

Conclusion: N/L ratio, an easily available laboratory data, may be related to microvascular reperfusion in STEMI patients with electrocardiographic sign of SR.

Keywords: Electrocardiogram; Neutrophil/Lymphocyte ratio; ST elevation myocardial infarction; Spontaneous reperfusion.

MeSH terms

  • Aged
  • Electrocardiography
  • Female
  • Humans
  • Leukocyte Count
  • Lymphocytes / pathology*
  • Male
  • Middle Aged
  • Neutrophils / pathology*
  • ST Elevation Myocardial Infarction / pathology*
  • ST Elevation Myocardial Infarction / physiopathology