Comparison of neutrophil-to-lymphocyte ratio and mean platelet volume in the prediction of adverse events after primary percutaneous coronary intervention in patients with ST-elevation myocardial infarction

Autor: Sandro Cadaval Gonçalves, Rodrigo Vugman Wainstein, Guilherme Pinheiro Machado, Mateus Correa Lech, Gustavo Neves de Araújo, Marco Vugman Wainstein, Felipe Homem Valle, Stéfani Mariani, Christian Kunde Carpes, Luiz Carlos Corsetti Bergoli
Rok vydání: 2018
Předmět:
Blood Platelets
Male
medicine.medical_specialty
Time Factors
Neutrophils
medicine.medical_treatment
030204 cardiovascular system & hematology
Risk Assessment
03 medical and health sciences
0302 clinical medicine
Percutaneous Coronary Intervention
Predictive Value of Tests
Risk Factors
Internal medicine
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Myocardial infarction
Lymphocyte Count
Lymphocytes
Prospective Studies
Neutrophil to lymphocyte ratio
Mean platelet volume
Prospective cohort study
Aged
Receiver operating characteristic
business.industry
fungi
Percutaneous coronary intervention
Reproducibility of Results
Middle Aged
medicine.disease
Treatment Outcome
Conventional PCI
Cardiology
ST Elevation Myocardial Infarction
Female
Cardiology and Cardiovascular Medicine
business
Mean Platelet Volume
Mace
Zdroj: Atherosclerosis. 274
ISSN: 1879-1484
Popis: Elevated neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV) are indirect inflammatory markers. There is some evidence that both are associated with worse outcomes in ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI). The aim of the present study was to compare the capacity of NLR and MPV to predict adverse events after primary PCI.In a prospective cohort study, 625 consecutive patients with STEMI, who underwent primary PCI, were followed. Receiver operating characteristic (ROC) curve analysis was performed to calculate the area under the curve (AUC) for the occurrence of procedural complications, mortality and major adverse cardiovascular events (MACE).Mean age was 60.7 (±12.1) years, 67.5% were male. The median of NLR was 6.17 (3.8-9.4) and MPV was 10.7 (10.0-11.3). In multivariate analysis, both NLR and MPV remained independent predictors of no-reflow (relative risk [RR] = 2.26; 95%confidence interval [95%CI] = 1.16-4.32; p = 0.01 and RR = 2.68; 95%CI = 1.40-5.10; p 0.01, respectively), but only NLR remained an independent predictor of in-hospital MACE (RR = 1.01; 95%CI = 1.00-1.06; p = 0.02). The AUC for in-hospital MACE was 0.57 for NLR (95%CI = 0.53-0.60; p = 0.03) and 0.56 for MPV (95%CI = 0.52-0.60; p = 0.07). However, when AUC were compared with DeLong test, there was no statistically significant difference for these outcomes (p 0.05). NLR had an excellent negative predictive value (NPV) of 96.7 for no-reflow and 89.0 for in-hospital MACE.Despite no difference in the ROC curve comparison with MPV, only NLR remained an independent predictor for in-hospital MACE. A low NLR has an excellent NPV for no-reflow and in-hospital MACE, and this could be of clinical relevance in the management of low-risk patients.
Databáze: OpenAIRE
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