Department of Cardiology, Mustafa Kemal University, Tayfur Ata Sokmen Medical School, 06270 Hatay, Turkey.
Atherosclerosis. 2013 May;228(1):203-10. doi: 10.1016/j.atherosclerosis.2013.02.017. Epub 2013 Feb 24.
In the present study we aimed to reveal any probable correlation between neutrophil-to-lymphocyte ratio (N/L ratio) and the occurrence of no-reflow, along with assessment of the prognostic value of N/L ratio in patients with ST-segment elevation myocardial infarction (STEMI).
The N/L ratio stands practically for the balance between neutrophil and lymphocyte counts in the body, which can also be utilized as an index for systemic inflammatory status.
In our study, we included 204 consecutive patients suffering from STEMI who underwent primary percutaneous coronary intervention (PCI). Patients with STEMI were assigned into distinct tertiles based on their N/L ratios on admission. No-reflow encountered following PCI was evaluated through both angiography [Thrombolysis in Myocardial Infarction (TIMI) flow and myocardial blush grade (MBG)] and electrocardiography (as ST-segment resolution).
Patients featured with no ST-resolution were documented to have displayed significantly higher N/L ratio on admission compared to those with intermediate or complete ST-segment resolution. The number of the patients characterized with no-reflow, evident both angiographically (TIMI flow ≤ 2 or TIMI flow 3 with final myocardial bush grade ≤ 2 after PCI) and electrocardiographically (ST-resolution <30%), was encountered to depict increments throughout successive N/L ratio tertiles. Moreover, the same also held true for three-year mortality rates across the tertile groups (9% vs. 15% vs. 35%, p < 0.01). Multivariable logistic regression analysis disclosed that N/L ratio on admission stood for a significant indicator for long-term mortality in patients with no-reflow phenomenon detected with MBG. Elevated N/L ratio on admission was also found to be a significant indicator for three-year mortality and major adverse cardiac events.
In patients with STEMI who underwent primary PCI, elevated N/L ratios on admission were revealed to be correlated with both no-reflow phenomenon and long-term prognosis.
本研究旨在揭示中性粒细胞与淋巴细胞比值（N/L 比值）与无复流现象之间可能存在的相关性，并评估其在 ST 段抬高型心肌梗死（STEMI）患者中的预后价值。
N/L 比值实际上代表了体内中性粒细胞和淋巴细胞计数之间的平衡，也可用作全身炎症状态的指标。
我们纳入了 204 例接受直接经皮冠状动脉介入治疗（PCI）的 STEMI 连续患者。根据入院时的 N/L 比值，将 STEMI 患者分为不同的三分位组。通过血管造影[心肌梗死溶栓治疗（TIMI）血流和心肌灌注分级（MBG）]和心电图（ST 段缓解）评估 PCI 后的无复流情况。
无 ST 段缓解的患者入院时的 N/L 比值明显高于有中间或完全 ST 段缓解的患者。无复流的患者数量（血管造影表现为 TIMI 血流≤2 或 TIMI 血流 3 但 PCI 后最终 MBG≤2，心电图表现为 ST 段缓解<30%）随着 N/L 比值三分位组的递增而增加。此外，三组的 3 年死亡率也呈递增趋势（9%比 15%比 35%，p<0.01）。多变量逻辑回归分析显示，入院时的 N/L 比值是 MBG 检测到无复流现象的患者长期死亡率的重要指标。入院时升高的 N/L 比值也是 3 年死亡率和主要不良心脏事件的重要指标。
在接受直接 PCI 的 STEMI 患者中，入院时升高的 N/L 比值与无复流现象和长期预后相关。
