Predictive value of neutrophil to lymphocyte ratio in outcomes of patients with acute coronary syndrome

Arch Med Res. 2010 Nov;41(8):618-22. doi: 10.1016/j.arcmed.2010.11.006.


Background and aims: Acute coronary syndrome (ACS) is associated with many hereditary and acquired predisposing factors. It has been recently shown that inflammation may play a role in myocardial ischemia. Hence, the white blood cell (WBC) count provides a simple and inexpensive method for assessment of inflammatory status in patients with ACS. An elevated WBC count has been associated with cardiovascular risk, but which leukocyte subtype carries this risk is uncertain. The aim of this study was to investigate the utility of admission neutrophil/lymphocyte ratio (NLR) in predicting the likelihood of poor outcomes in patients with ACS.

Methods: A total of 300 consecutive patients admitted to the Internal Medicine Department, Sohar Hospital, Oman with the diagnosis of ACS from June 2008 to May 2009 were included in this study. Patients were divided into tertile groups according to the NLR. The primary end point was all-cause in-hospital mortality at the end of 30 days.

Results: The mean age of patients included in this cohort was 61 years, with 63% of male patients. The mortality in the three groups based on NLR was 4, 10 and 19%, in the low-, middle- and high-risk groups, respectively (p <0.003; χ² test).

Conclusions: Admission NLR is clearly an independent predictor of all-cause mortality in patients with ACS.

MeSH terms

  • Acute Coronary Syndrome / blood*
  • Acute Coronary Syndrome / therapy*
  • Aged
  • Humans
  • Lymphocyte Count
  • Lymphocytes / cytology*
  • Male
  • Middle Aged
  • Neutrophils / cytology*
  • Predictive Value of Tests*
  • Retrospective Studies
  • Treatment Outcome