Uzma Gul1, Azhar Mehmood Kayani1, Rubab Munir2, Sajjad Hussain3. 1. Department of Cardiology, Rawalpindi Institute of Cardiology (RIC), Rawalpindi. 2. Research and Development, Rawalpindi Institute of Cardiology (RIC), Rawalpindi. 3. Department of Cardiology, Armed Forces Institute of Cardiology, Rawalpindi.
Abstract
OBJECTIVE: To investigate if neutrophil lymphocyte ratio (NLR) predicts in-hospital adverse events and mortality, and shortterm (30-day) mortality in ST-elevated myocardial infarction (STEMI) patients thrombolysed with streptokinase (SK). STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Rawalpindi Institute of Cardiology, from June 2014 till January 2015. METHODOLOGY: The STEMI patients, thrombolysed with SK had blood samples at admission, analysed for complete blood counts and NLR calculated. They were grouped into two, low and high NLR, taking 4.50 as cut-off. Chi square test was used to compare rate of adverse events and death in hospital stay. Mann-Whitney test was used to compare median NLR between patients died and discharged alive. Logistic regression analysis was used to estimate predictive ability of NLR for 30-day mortality. RESULTS: Atotal of 145 (45.3%) patients had complications; 49 (15.3%) died in hospital, and 13 (4.06%) died in 30 days. Patients in high NLR group had higher rate of complications (63.5% vs. 25.5%, p <0.0001) and death (19.2% vs. 11.1%, p=0.046) in hospital than those in low NLR group. Cardiogenic shock (27.5% vs.11.1%, p <0.0001), heart failure (19.2% vs. 7.2%, p=0.002), arrhythmias (18% vs. 6.5%, p <0.0001), reinfarct/angina (9.6% vs.2% p=0.004) occurred more in high NLR group. Median NLR in patients died was higher than those discharged alive (7.46 vs. 4.70, p <0.0001). Regression analysis showed NLR an independent predictor of mortality (OR 1.131 at 95% CI, p = 0.029). Age, serum creatinine, Killip class were other predictors (p=0.002 and p=0.02, respectively). ROC curve showed AUC 0.908 (p <0.0001). CONCLUSION: Ahigh NLR predicted increased in hospital complication rate, and in-hospital as well as 30-day mortality in STEMI patients thrombolysed with streptokinase.
OBJECTIVE: To investigate if neutrophil lymphocyte ratio (NLR) predicts in-hospital adverse events and mortality, and shortterm (30-day) mortality in ST-elevated myocardial infarction (STEMI) patients thrombolysed with streptokinase (SK). STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Rawalpindi Institute of Cardiology, from June 2014 till January 2015. METHODOLOGY: The STEMI patients, thrombolysed with SK had blood samples at admission, analysed for complete blood counts and NLR calculated. They were grouped into two, low and high NLR, taking 4.50 as cut-off. Chi square test was used to compare rate of adverse events and death in hospital stay. Mann-Whitney test was used to compare median NLR between patients died and discharged alive. Logistic regression analysis was used to estimate predictive ability of NLR for 30-day mortality. RESULTS: Atotal of 145 (45.3%) patients had complications; 49 (15.3%) died in hospital, and 13 (4.06%) died in 30 days. Patients in high NLR group had higher rate of complications (63.5% vs. 25.5%, p <0.0001) and death (19.2% vs. 11.1%, p=0.046) in hospital than those in low NLR group. Cardiogenic shock (27.5% vs.11.1%, p <0.0001), heart failure (19.2% vs. 7.2%, p=0.002), arrhythmias (18% vs. 6.5%, p <0.0001), reinfarct/angina (9.6% vs.2% p=0.004) occurred more in high NLR group. Median NLR in patients died was higher than those discharged alive (7.46 vs. 4.70, p <0.0001). Regression analysis showed NLR an independent predictor of mortality (OR 1.131 at 95% CI, p = 0.029). Age, serum creatinine, Killip class were other predictors (p=0.002 and p=0.02, respectively). ROC curve showed AUC 0.908 (p <0.0001). CONCLUSION: Ahigh NLR predicted increased in hospital complication rate, and in-hospital as well as 30-day mortality in STEMI patients thrombolysed with streptokinase.
Authors: Chen Chen; Bai Lin Cong; Min Wang; Muhammad Abdullah; Xiao Long Wang; Yin Hua Zhang; Shun Ji Xu; Lan Cui Journal: Integr Med Res Date: 2018-03-08