Prognostic value of neutrophil‐lymphocyte ratio in cardiogenic shock complicating acute myocardial infarction: A cohort study
| Autor: | Zhenxian Xiang, Xiankang Hu, Yuzhou Xue, Bryan Richard Sasmita, Hongbo Gan, Suxin Luo, Yuansong Zhu, Bi Huang |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Neutrophils medicine.drug_class Myocardial Infarction Shock Cardiogenic Ventricular tachycardia Cohort Studies Internal medicine Heart rate medicine Natriuretic peptide Humans Lymphocytes cardiovascular diseases Myocardial infarction Stroke business.industry Cardiogenic shock fungi General Medicine Prognosis medicine.disease Ventricular fibrillation Cardiology business Mace |
| Zdroj: | International Journal of Clinical Practice. 75 |
| ISSN: | 1742-1241 1368-5031 |
| Popis: | Cardiogenic shock (CS) is the most severe complication after acute myocardial infarction (AMI) with mortality above 50%. Inflammatory response is involved in the pathology of CS and AMI. In this study, we aimed to evaluate the prognostic value of admission neutrophil-lymphocyte ratio (NLR) in patients with CS complicating AMI.Two hundred and seventeen consecutive patients with CS after AMI were divided into two groups according to the admission NLR cut-off value ≤7.3 and7.3. The primary outcome was 30-day all-cause mortality and the secondary end-point was the composite events of major adverse cardiovascular events (MACE), including all-cause mortality, ventricular tachycardia/ventricular fibrillation, atrioventricular block, gastrointestinal haemorrhage and non-fatal stroke. Cox proportional hazard models were performed to analyse the association of NLR with the outcome. NLR cut-off value was determined by Youden index.Patients with NLR7.3 were older and presented with lower lymphocyte count, higher admission heart rate, B-type natriuretic peptide, leucocyte, neutrophil and creatinine (all P .05). During a period of 30-day follow-up after admission, mortality in patients with NLR7.3 was significantly higher than in patients with NLR ≤ 7.3 (73.7% vs. 26.3%, P .001). The incidence of MACE was also remarkably higher in patients with NLR7.3 (87.9% vs. 53.4%, P .001). After multivariable adjustment, NLR7.3 remained an independent predictor for higher risk of 30-day mortality (HR 2.806; 95%CI 1.784, 4.415, P .001) and MACE (HR 2.545; 95%CI 1.791, 3.617, P .001).Admission NLR could be used as an important tool for short-term prognostic evaluation in patients with CS complicating AMI and higher NLR is an independent predictor for increased 30-day all-cause mortality and MACE. |
| Databáze: | OpenAIRE |
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