Neutrophil-to-lymphocyte ratio predicts coronary artery lesion complexity and mortality after non-ST-segment elevation acute coronary syndrome

Abstract

Objective: Inflammatory mechanisms are known to play an important role in coronary artery disease. The present study aimed to investigate the importance of the neutrophil-to-lymphocyte ratio (NLR) in terms of in-hospital mortality and its association with currently used risk scores in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). Methods: Three hundred and seventeen patients with NSTE-ACS were included. The patients were divided into tertiles according to their NLR values (NLR <2.6, NLR=2.6-4.5, and NLR >4.5). Clinical and angiographic risk was evaluated by the SYNTAX and GRACE risk scores. Results: The GRACE risk score was significantly higher in the group with high NLR values compared to those with moderate or low NLR (161.5 +/- 40.3, 130.5 +/- 32.3, and 123.9 +/- 34.3, respectively, p<0.001). Similarly, the SYNTAX score was significantly higher in the group with high NLR values (20.4 +/- 10.1, 15.5 +/- 10.5, and 13.4 +/- 7.8, respectively, p=0.003). Moreover, both GRACE (r=0.457, p<0.001) and SYNTAX scores (r=0.253, p=0.001) showed a significant positive correlation with NLR. Conclusion: NLR has been found to be correlated with clinical and angiographic risk scores. Low NLR might be a good predictor for low in-hospital mortality and simple coronary anatomy in NSTE-ACS patients. (C) 2014 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.