The Role of Neutrophil to Lymphocyte Ratio and its Common Clinical Outcomes Among Patients with Non-ST Elevation Acute Coronary Syndrome

Javed Jalbani; Khalid I Bhatti; Muhammad T Sallar; Ahsan M Baig; Palwasha Tariq; Faisal Ahmed; Ali Ammar; Vicky Kumar

doi:10.37616/2212-5043.1340

The Role of Neutrophil to Lymphocyte Ratio and its Common Clinical Outcomes Among Patients with Non-ST Elevation Acute Coronary Syndrome

J Saudi Heart Assoc. 2023 Jul 3;35(2):177-182. doi: 10.37616/2212-5043.1340. eCollection 2023.

Authors

Javed Jalbani¹, Khalid I Bhatti¹, Muhammad T Sallar¹, Ahsan M Baig¹, Palwasha Tariq¹, Faisal Ahmed², Ali Ammar¹, Vicky Kumar¹

Affiliations

¹ National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan.
² Civil Hospital Karachi (CHK), Dow University of Health Sciences (DUHS), Karachi, Pakistan.

Abstract

Objectives: To evaluate the admission neutrophil-to-lymphocyte ratio (NLR) for risk stratification for in-hospital outcomes and complications in non-ST-elevation acute coronary syndrome (non-ST-ACS) patients.

Methods: We recruited consecutive patients with non-ST-ACS. The NLR was obtained and stratified as low, intermediate, and high-risk based on <3.0, 3.0-6.0, and >6.0, respectively. The new ST-T changes, arrhythmias, contrast-induced nephropathy (CIN), and mortality were recorded.

Results: Median NLR was 3 [2.1-5.3] for 346 patients with 19.9% and 30.6% in high- and intermediate-risk group. New ST-T changes were observed in 3.5% (12) out of which 8, 3, and 1 patient in low, intermediate, and high-risk group (p = 0.424), respectively. Arrhythmias were observed in 5.8% (20) with 7, 5, and 8 patients in low, intermediate, and high-risk group (p = 0.067), respectively. CIN was observed in 4.9% (17) with 5, 5, and 7 in low, intermediate, and high-risk group (p = 0.064), respectively. In-hospital mortality was recorded in 1.4% (5) with 2 and 3 patients in high and low-risk group (p = 0.260), respectively.

Conclusion: A significant number of non-ST-ACS patients fall in the high-risk category of NLR. Although, the association between NLR and in-hospital mortality and adverse events was not statistically significant but relatively higher rates of events were observed in high risk group.

Keywords: Atherosclerotic cardiovascular diseases (ASCVD); Neutrophil to lymphocyte ratio (NLR); Non-ST-elevation acute coronary syndrome (non-ST ACS); Pakistan; Prognosis.