Kurtul Alparslan, Yarlioglues Mikail, Duran Mustafa, Murat Sani Namik
Ankara Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
Ankara Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
Heart Lung Circ. 2016 Jul;25(7):683-90. doi: 10.1016/j.hlc.2016.01.007. Epub 2016 Feb 11.
A higher neutrophil-to-lymphocyte ratio (NLR) is associated with poor clinical outcomes in various cardiovascular diseases, including acute coronary syndromes. However, the relationship between NLR and contrast-induced nephropathy (CIN) in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) undergoing percutaneous coronary intervention (PCI) has not been known. Hence, we investigated whether admission NLR is associated with CIN after PCI in patients with NSTE-ACS.
A total of 478 patients (mean age 62.8±12.6 years, and 64.2% men), who were admitted to our hospital for NSTEACS and underwent PCI with stent, were recruited. Neutrophil-to-lymphocyte ratio was calculated via dividing neutrophil count by lymphocyte count. The patients were divided into two groups: CIN (+) and CIN (-). Contrast-induced nephropathy was defined as a ≥0.5mg/dL and/or a ≥25% increase in serum creatinine within 48-72hours post-PCI.
Admission NLR was significantly higher in patients with CIN than in patients without CIN (median 5.43, interquartile range 3.23-7.73 vs. median 2.59, interquartile range 1.83-3.88, P<0.001). On multivariate analysis, NLR ≥ 3.46 value (OR=2.631, 95%CI 1.146-6.060, P=0.022), estimated glomerular filtration rate (OR=0.963, P=0.004), high sensitivity C-reactive protein (OR=1.028, P=0.016) were independent factors of CIN.
Increased NLR is independently associated with risk of CIN in NSTE-ACS patients treated by PCI.
较高的中性粒细胞与淋巴细胞比值（NLR）与包括急性冠脉综合征在内的多种心血管疾病的不良临床结局相关。然而，在接受经皮冠状动脉介入治疗（PCI）的非ST段抬高型急性冠脉综合征（NSTE-ACS）患者中，NLR与造影剂肾病（CIN）之间的关系尚不清楚。因此，我们研究了NSTE-ACS患者PCI术后入院时的NLR是否与CIN相关。
共纳入478例因NSTE-ACS入院并接受支架植入PCI的患者（平均年龄62.8±12.6岁，男性占64.2%）。中性粒细胞与淋巴细胞比值通过中性粒细胞计数除以淋巴细胞计数计算得出。患者分为两组：CIN（+）组和CIN（-）组。造影剂肾病定义为PCI术后48 - 72小时内血清肌酐升高≥0.5mg/dL和/或≥25%。
CIN患者入院时的NLR显著高于无CIN患者（中位数5.43，四分位数间距3.23 - 7.73 vs.中位数2.59，四分位数间距1.83 - 3.88，P<0.001）。多因素分析显示，NLR≥3.46（OR = 2.631，95%CI 1.146 - 6.060，P = 0.022）、估计肾小球滤过率（OR = 0.963，P = 0.004）、高敏C反应蛋白（OR = 1.028，P = 0.016）是CIN的独立影响因素。
NSTE-ACS患者PCI术后，NLR升高与CIN风险独立相关。
