Xiqiang Wang1, Xiude Fan2, Shuaifei Ji3, Aiqun Ma4, Tingzhong Wang5. 1. Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, PR China. 2. Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, PR China. 3. Department of Ophthalmology, TangDu Hospital, The Fourth Military University, Xi'an 710032, Shaanxi, PR China. 4. Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, PR China; Key Laboratory of Molecular Cardiology, Shaanxi Province, PR China; Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, PR China. Electronic address: maaiqun@medmail.com.cn. 5. Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, PR China; Key Laboratory of Molecular Cardiology, Shaanxi Province, PR China; Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, Ministry of Education, PR China. Electronic address: tingzhong.wang@mail.xjtu.edu.cn.
Abstract
BACKGROUND: Neutrophil to lymphocyte ratio (NLR) has been indicated to be an independent predictor for all-cause mortality or adverse events in a variety of diseases. However, no consistent conclusions regarding it's relevance to patients with heart failure have been made. This meta-analysis was conducted to assess the significance of NLR in patients with heart failure. METHODS: Pubmed and Embase databases were searched for eligible studies that reported the association between NLR and heart failure through September 2017. The overall hazard ratio (HR) and corresponding 95% confidence interval (CI) were used to assess the associations. RESULTS: Ten studies met the eligibility criteria and a total of 5979 heart failure patients were included in the meta-analysis. The overall hazard ratio (HR) for all-cause mortality was 1.28 (95% CI 1.14-1.43) and the HR of renal dysfunction was 1.23 (95% CI 1.07-1.41) comparing the highest with the lowest category of NLR. However, the total pooled adjusted HR for in-hospital mortality (HR = 1.18, 95% CI 0.88-1.59) and rehospitalization (HR = 2.19, 95% CI 0.94-5.09) were not statistically significant. A subgroup analysis showed that sample size with moderate heterogeneity may be the origin of heterogeneity in all-cause mortality. Sensitivity analysis proved the stability of results of our meta-analysis. CONCLUSIONS: The meta-analysis demonstrates that NLR is a predictor of all-cause mortality in patients with heart failure. Because the quality of the included studies varies, further well-designed studies are needed to confirm this association.
BACKGROUND: Neutrophil to lymphocyte ratio (NLR) has been indicated to be an independent predictor for all-cause mortality or adverse events in a variety of diseases. However, no consistent conclusions regarding it's relevance to patients with heart failure have been made. This meta-analysis was conducted to assess the significance of NLR in patients with heart failure. METHODS: Pubmed and Embase databases were searched for eligible studies that reported the association between NLR and heart failure through September 2017. The overall hazard ratio (HR) and corresponding 95% confidence interval (CI) were used to assess the associations. RESULTS: Ten studies met the eligibility criteria and a total of 5979 heart failurepatients were included in the meta-analysis. The overall hazard ratio (HR) for all-cause mortality was 1.28 (95% CI 1.14-1.43) and the HR of renal dysfunction was 1.23 (95% CI 1.07-1.41) comparing the highest with the lowest category of NLR. However, the total pooled adjusted HR for in-hospital mortality (HR = 1.18, 95% CI 0.88-1.59) and rehospitalization (HR = 2.19, 95% CI 0.94-5.09) were not statistically significant. A subgroup analysis showed that sample size with moderate heterogeneity may be the origin of heterogeneity in all-cause mortality. Sensitivity analysis proved the stability of results of our meta-analysis. CONCLUSIONS: The meta-analysis demonstrates that NLR is a predictor of all-cause mortality in patients with heart failure. Because the quality of the included studies varies, further well-designed studies are needed to confirm this association.