Neutrophil-to-lymphocyte ratio as a predictor of left ventricle function and mortality in patients with myocardial infarction.

INTRODUCTION

Myocardial infarction (MI) is a complex clinical syndrome that significantly influences long-term outcomes through its effects on myocardial remodeling, heart failure progression, and mortality. Despite extensive research, there is still no consensus regarding optimal biomarkers for risk stratification of MI patients in terms of long-term outcomes.

AIM

The study aimed to assess neutrophil-to-lymphocyte ratio (NLR) and evaluate the association between this ratio and long-term clinical and echocardiographic outcomes in patients hospitalized for MI.

MATERIAL AND METHODS

A total of 412 patients hospitalized for MI between 2016 and 2019 were screened. Demographic data, baseline clinical characteristics, typical biochemical parameters, and angiographic and echocardiographic findings were analyzed. Patients underwent long-term clinical and echocardiographic follow-up.

RESULTS

NLR correlated negatively with both baseline and follow-up left ventricular ejection fraction (LVEF) ( = -0.214; = 0.043 and = -0.3; < 0.001, respectively). In regression analysis, NLR was a significant predictor of long-term reduced LVEF (defined as a value < 40%) (OR = 4.01; < 0.001) as well as all-cause mortality (OR = 1.16; = 0.008). In receiver operating characteristic (ROC) analysis, NLR demonstrated significant predictive value for mortality (AUC = 0.65; = 0.04) with an optimal cut-off point of 8.7 (Youden index = 0.4). Kaplan-Meier analysis revealed that patients with NLR > 8.7 had significantly poorer survival compared to those with lower NLR values ( < 0.001).

CONCLUSIONS

Elevated NLR was associated with poorer left ventricular function and increased mortality in patients after MI during long-term observation.