Na Xu1,2, Xiao-Fang Tang1,2, Yi Yao1,2, Xueyan- Zhao1,2, Jue- Chen1,2, Zhan- Gao1,2, Yuejin- Yang1,2, Run-Lin Gao1,2, Bo Xu1,2, Jin-Qing Yuan1,2. 1. State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Road No. 167, Xicheng District, Beijing, 100037, People's Republic of China. 2. Peking Union Medical College, Beijing, 100037, People's Republic of China.
Abstract
OBJECTIVES: We sought to evaluate the independent predictive value of left main disease (LMD) and/or three-vessel disease (LMD/3VD) in acute myocardial infarction (AMI) patients. BACKGROUND: Patients with acute coronary syndrome resulting from LMD and/or three-vessel disease (LMD/3VD) are at the highest risk of adverse cardiovascular events. Neutrophil to lymphocyte ratio (NLR) has been proposed as a marker of cardiovascular risk, but the prognostic value of NLR in patients with LMD/3VD who underwent percutaneous coronary intervention (PCI) is not clearly defined. METHODS: Patients (n = 806) admitted with LMD/3VD who underwent PCI between January 2013 and December 2013 were followed up for 2 years. Admission NLR was divided into two sub-groups based on an optimal cut off value predicting 2-year all-cause mortality. The primary end point was all-cause death. The secondary end point was long-term major adverse cardiovascular and cerebrovascular events (MACCE). RESULTS: During follow-up, the high NLR group was associated with a significantly higher rate of long-term all-cause mortality (6.7 vs. 0.9%, P < .001), and MACCE (24.7 vs. 15.8%, P = .002) compared to the low NLR group. In multivariate analysis, after adjusting for risk factors, NLR ≥ 3.39 was determined to be an independent predictor of 2-year all-cause mortality (hazard ratio[HR] 3.08, 95% confidence interval [CI] 1.06 to 8.97, P = .039) and MACCE (hazard ratio 1.44, 95% CI 1.01 to 2.05, P = .046) for LMD/3VD. CONCLUSIONS: The admission NLR as relatively inexpensive marker of inflammation may aid in the risk stratification and prognosis of patients diagnosed with LMD/3VD.
OBJECTIVES: We sought to evaluate the independent predictive value of left main disease (LMD) and/or three-vessel disease (LMD/3VD) in acute myocardial infarction (AMI) patients. BACKGROUND:Patients with acute coronary syndrome resulting from LMD and/or three-vessel disease (LMD/3VD) are at the highest risk of adverse cardiovascular events. Neutrophil to lymphocyte ratio (NLR) has been proposed as a marker of cardiovascular risk, but the prognostic value of NLR in patients with LMD/3VD who underwent percutaneous coronary intervention (PCI) is not clearly defined. METHODS:Patients (n = 806) admitted with LMD/3VD who underwent PCI between January 2013 and December 2013 were followed up for 2 years. Admission NLR was divided into two sub-groups based on an optimal cut off value predicting 2-year all-cause mortality. The primary end point was all-cause death. The secondary end point was long-term major adverse cardiovascular and cerebrovascular events (MACCE). RESULTS: During follow-up, the high NLR group was associated with a significantly higher rate of long-term all-cause mortality (6.7 vs. 0.9%, P < .001), and MACCE (24.7 vs. 15.8%, P = .002) compared to the low NLR group. In multivariate analysis, after adjusting for risk factors, NLR ≥ 3.39 was determined to be an independent predictor of 2-year all-cause mortality (hazard ratio[HR] 3.08, 95% confidence interval [CI] 1.06 to 8.97, P = .039) and MACCE (hazard ratio 1.44, 95% CI 1.01 to 2.05, P = .046) for LMD/3VD. CONCLUSIONS: The admission NLR as relatively inexpensive marker of inflammation may aid in the risk stratification and prognosis of patients diagnosed with LMD/3VD.