Predictive and prognostic value of admission neutrophil-to-lymphocyte ratio in patients with CHD.

BACKGROUND AND AIM

The aim of this study was to examine the association between the admission neutrophil-to-lymphocyte ratio (N/L ratio) with coronary heart disease (CHD), separately from acute coronary syndrome (ACS) and stable angina (SA). A further aim was to investigate the clinical value of the N/L ratio in predicting in-hospital CHD events and the long-term prognosis of patients with CHD.

PATIENTS AND METHODS

In all, 942 patients were enrolled and classified into a CHD group (comprising an ACS group and an SA group) and a normal group. Laboratory data including regular blood test results were obtained at baseline. The relationship between the N/L ratio and CHD, ACS, Gensini score, and multivessel lesions was analyzed by logistic regression. Receiver operating characteristics (ROC) curve analysis was used to identify the value of the N/L ratio in the diagnosis of CHD, ACS, and the severity of CHD. We divided the patients into four groups according to the N/L ratio quartiles and compared the differences in major adverse cardiac events (MACEs) that occurred in hospital and in the 4.26 ± 0.57-year follow-up out of hospital.

RESULTS

Patients with an elevated N/L ratio had a significantly increased risk of CHD [odds ratio (OR) = 1.697, 95 % confidence interval (CI) = 1.483-1.942], and an elevated N/L ratio was closely related to a higher risk of ACS (OR = 1.652, 95 % CI = 1.434-1.902). The admission N/L ratio (0.664; 95 % CI = 1.942-1.616) showed a greater ROC area than the WBC and LDL-C values. Patients with a higher N/L ratio in both the SA group and the ACS group had a higher incidence of in-hospital and out-of-hospital MACEs, including long-term mortality and occurrence of new-onset heart failure or re-occurrence of heart failure. An elevated N/L ratio on admission was also found to be a significant indicator of 4.26-year MACEs.

CONCLUSION

The admission N/L ratio was significantly associated with CHD and may become a risk predictor in the prognosis of patients with CHD.