Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio are Important Indicators for Predicting in-Hospital Death in Elderly AMI Patients

Yan Chen; Shengyue Chen; Yuanyuan Han; Qing Xu; Xin Zhao

doi:10.2147/JIR.S411086

Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio are Important Indicators for Predicting in-Hospital Death in Elderly AMI Patients

J Inflamm Res. 2023 May 15:16:2051-2061. doi: 10.2147/JIR.S411086. eCollection 2023.

Authors

Yan Chen^#¹, Shengyue Chen^#¹, Yuanyuan Han¹, Qing Xu¹, Xin Zhao¹

Affiliation

¹ Department of Cardiology, the Second Hospital of Dalian Medical University, Dalian, People's Republic of China.

^# Contributed equally.

Abstract

Aim: To investigate the role of neutrophil-to-lymphocyte ratio(NLR) and platelet-to-lymphocyte(PLR) in predicting the risk of in-hospital mortality in elderly acute myocardial infarction(AMI) patients.

Methods: This study was a single-center, retrospective and observational study. From December 2015 to December 2021, a total of 1550 elderly patients (age ≥ 60 years) with AMI with complete clinical history data were enrolled in the Second Hospital of Dalian Medical University. Routine blood tests were performed on admission, and NLR and PLR were calculated based on neutrophil, platelet, and lymphocyte counts. Outcome was defined as all-cause mortality during hospitalization. Cox regression and restricted spline cubic(RCS) models were used to evaluate the association of NLR and in-hospital mortality risk and the association of PLR with in-hospital mortality risk, respectively.

Results: (1) A total of 132 (8.5%) patients died during hospitalization. From the results of blood routine, the white blood cell, neutrophil, NLR and PLR in the death group were higher than those in the non-death group, while the lymphocyte was lower than that in the non-death group, and the difference was statistically significant (P < 0.05). (2) The results of receiver operating characteristic(ROC) curves analysis showed that the predictive ability of NLR (AUC = 0.790) for in-hospital death was better than that of PLR (AUC = 0.637). (3) Multivariate Cox proportional regression hazard models showed that high NLR was associated with the risk of in-hospital mortality in elderly AMI patients (HR = 3.091, 95% CI 2.097-4.557, P < 0.001), while high PLR was not. (4) RCS models showed a nonlinear dose-response relationship between NLR and in-hospital death (P for nonlinear = 0.0007).

Conclusion: High NLR (> 6.69) is associated with the risk of in-hospital mortality in elderly patients with AMI and can be an independent predictor of poor short-term prognosis in elderly patients with AMI.

Keywords: acute myocardial infarction; neutrophil to lymphocyte; platelet-to-lymphocyte ratio; prognosis; restricted cubic splines.

Grants and funding

This study was funded by the Liaoning Provincial “Selecting the Best Candidates by Opening Competition Mechanism” Science and Technology Program (grant number 2022JH1/10400004).