FREQUENCY OF IN HOSPITAL MORTALITY IN PATIENTS WITH HIGH NEUTROPHIL/LYMPHOCYTE RATIO PRESENTING WITH ST ELEVATION MYOCARDIAL INFARCTION

Abstract

Objective: To determine the frequency of in-hospital mortality in patients with high NLR presenting with STEMI.

Methodology: Consecutive patients with STEMI and high NLR presenting at Cardiology department, Lady Reading Hospital, Peshawar were evaluated for our study. Out of the 236 patients admitted from 1^st September 2015 to 28^th February 2016, 191 patients qualified for study inclusion. NLR was calculated by dividing the total number of neutrophils over the total number of lymphocytes obtained via a computerized heamogram. A high NLR was defined as value >4.7. In hospital mortality and the effect of various class of patients with or without conventional risk factors was assessed.

Results: The mean high NLR in study population was 6.38±1.28. In-hospital mortality due to cardiac cause was 12% (n=23) which included 8.37% (n=16) males. Statistically significant higher values of mean high NLR were found to be associated with in-hospital mortality and presence of conventional risk factors including hypertension, diabetes, and smoking with the exception of hypercholesterolemia. Among the patients who died, more had adverse events in form of higher Killip class and arrythmias.

Conclusion: High NLR has fair prognostic value in patients presenting with acute STEMI. Raised values correlate well with the presence of conventional risk factors which increase the risk of post MI adverse events and appears additive to conventional risk factors and biomarkers.

Key Words: ST elevation myocardial infarction (STEMI), Neutrophil to lymphocyte ratio (NLR), Total leucocyte count (TLC), Coronary artery disease (CAD), Acute coronary syndrome (ACS)