Benites-Zapata Vicente A, Hernandez Adrian V, Nagarajan Vijaiganesh, Cauthen Clay A, Starling Randall C, Tang W H Wilson
Unidad de Análisis y Generación de Evidencia en Salud Pública, Instituto Nacional de Salud, Lima, Peru.
Faculty of Health Sciences, Postgraduate and Medical Schools, Universidad Peruana de Ciencias Aplicadas, Lima, Peru; Health Outcomes and Clinical Epidemiology Section, Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio.
Am J Cardiol. 2015 Jan 1;115(1):57-61. doi: 10.1016/j.amjcard.2014.10.008. Epub 2014 Oct 13.
Elevated neutrophil-to-lymphocyte ratio (NLR) has been associated with increased mortality in patients with acute heart failure (HF) and neoplastic diseases. We investigated the association between NLR and mortality or cardiac transplantation in a retrospective cohort of 527 patients presented to the Cleveland Clinic for evaluation of advanced HF therapy options from 2007 to 2010. Patients were divided according to low, intermediate, and high tertiles of NLR and were followed longitudinally for time to all-cause mortality or heart transplantation (primary outcome). The median NLR was 3.9 (interquartile range 2.5 to 6.5). In univariate analysis, intermediate and highest tertiles of NLR had a higher risk than the lowest tertile for the primary outcome and all-causes mortality. Compared with the lowest tertile, there was no difference in the risk of heart transplantation for intermediate and high tertiles. In multivariate analysis, compared with the lowest tertile, the intermediate and high NLR tertiles remained significantly associated with the primary outcome (hazard ratio [HR] = 1.61, 95% confidence interval [CI] 1.10 to 2.37 and HR = 1.55, 95% CI 1.02 to 2.36, respectively) and all-cause mortality (HR = 1.83, 95% CI 1.07 to 3.14 and HR = 2.16, 95% CI 1.21 to 3.83, respectively). In conclusion, elevated NLR is associated with increased mortality or heart transplantation risk in patients with advanced HF.
中性粒细胞与淋巴细胞比值（NLR）升高与急性心力衰竭（HF）和肿瘤疾病患者的死亡率增加有关。我们在一个回顾性队列中调查了NLR与死亡率或心脏移植之间的关联，该队列包括2007年至2010年因评估晚期HF治疗方案而就诊于克利夫兰诊所的527例患者。根据NLR的低、中、高三分位数对患者进行分组，并对全因死亡率或心脏移植时间（主要结局）进行纵向随访。NLR的中位数为3.9（四分位间距为2.5至6.5）。在单变量分析中，NLR的中三分位数和高三分位数比低三分位数发生主要结局和全因死亡率的风险更高。与低三分位数相比，中三分位数和高三分位数的心脏移植风险没有差异。在多变量分析中，与低三分位数相比，NLR的中三分位数和高三分位数仍与主要结局（风险比[HR]=1.61，95%置信区间[CI]为1.10至2.37；HR=1.55，95%CI为1.02至2.36）和全因死亡率（HR=1.83，95%CI为1.07至3.14；HR=2.16，95%CI为1.21至3.83）显著相关。总之，NLR升高与晚期HF患者的死亡率增加或心脏移植风险增加有关。
