Neutrophil/lymphocyte ratio is associated with right ventricular dysfunction in patients with acute inferior ST-segment elevation myocardial infarction

Cardiol J. 2016;23(1):100-6. doi: 10.5603/CJ.a2015.0061. Epub 2015 Sep 28.

Abstract

Background: Acute inferior ST-segment elevation myocardial infarction (STEMI) is associated with increased in-hospital morbidity and mortality particularly among patients with coexisting right ventricular (RV) involvement. High neutrophil to lymphocyte ratio (NLR) is an independent predictor of major adverse cardiac events and mortality in patients with myocardial infarction. This study evaluated the relationship between the NLR and RV dysfunction (RVD) in patients with inferior STEMI who underwent primary percutaneous coronary intervention (PCI).

Methods: A total of 213 subjects with inferior STEMI were divided into two groups according to the presence of RVD. The groups were compared according to NLR and receiver operating characteristic (ROC) analysis was performed to access the predictability of NLR on having RVD.

Results: The NLR was significantly higher in the group with RVD compared to that without RVD (p < 0.001). In ROC analysis, NLR > 3.5 predicted RVD with sensitivity of 83% and specificity of 55%. In a multivariate regression analysis, NLR remained an independent predictor of RVD (OR 1.55, 95% CI 1.285-1.750, p < 0.001).

Conclusions: NLR was an independent predictor of RVD in patients with inferior STEMI undergoing primary PCI.

Keywords: inferior wall myocardial infarction; neutrophil/lymphocyte ratio; primary percutaneous coronary intervention; right ventricular dysfunction.

MeSH terms

  • Aged
  • Area Under Curve
  • Chi-Square Distribution
  • Female
  • Humans
  • Inferior Wall Myocardial Infarction / blood*
  • Inferior Wall Myocardial Infarction / complications
  • Inferior Wall Myocardial Infarction / diagnosis
  • Inferior Wall Myocardial Infarction / therapy
  • Logistic Models
  • Lymphocyte Count
  • Lymphocytes*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neutrophils*
  • Odds Ratio
  • Percutaneous Coronary Intervention
  • Predictive Value of Tests
  • Prospective Studies
  • ROC Curve
  • Risk Factors
  • Treatment Outcome
  • Ventricular Dysfunction, Right / diagnosis
  • Ventricular Dysfunction, Right / etiology*
  • Ventricular Dysfunction, Right / physiopathology
  • Ventricular Function, Right*