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Neutrophil-to-lymphocyte Ratio and Its Relation with Markers of Inflammation and Myocardial Necrosis in Patients with Acute Coronary Syndrome.
Med Arch. 2017 Oct; 71(5):312-315.MA

Abstract

Introduction

Inflammation plays an important role in atherosclerosis which is the primary cause of acute coronary syndrome (ACS) that encompasses acute myocardial infarction (AMI) and unstable angina (UA).

Objective

To investigate and characterize white blood cells (WBC) count, differential blood count in peripheral blood and neutrophil to lymphocyte ratio (NLR) in patients by the type of ACS.

Patients and methods

The cross-sectional study included 100 patients with ACS (50 males, 50 females), aged 41 to 91 years, classified into two groups: AMI group (n=50) and UA group (n=50). Patients were hospitalized at the Clinic for Heart Diseases, University Clinical Center of Sarajevo. From patients' medical histories the following data were obtained: WBC, neutrophil, eosinophil and basophil granulocytes count, monocyte and lymphocyte count, levels of high sensitive troponin I (hsTnI), creatine kinase MB (CK-MB) and C-reactive protein (CRP). The results were analyzed using software package SPSS, version 19.0.

Results

Average WBC count, neutrophil granulocytes, and monocytes were significantly higher in AMI group than in UA group (p = 0.001, p < 0.0005, p = 0.03, respectively). Eosinophil count was significantly lower in patients with AMI (p = 0.022). NLR was significantly higher in AMI group in relation to patients with UA (p = 0.001). Significantly higher values of hsTnI and CK-MB were established in patients with AMI. NLR correlated significantly positive with the values of hsTnI, CK-MB, CRP, WBC and neutrophil count, and significantly negative with lymphocyte count.

Conclusion

Average values of NLR were significantly higher in patients with AMI in relation to patients with UA, indicating the importance of this inflammatory marker in discrimination of clinical forms of ACS. A positive correlation was established between NLR and markers of myocardial necrosis, and between NLR and CRP, indicating the importance of NLR in the assessment of the extent of the myocardial lesion and in inflammation intensity assessment in ACS.

Authors+Show Affiliations

Department of Intensive Care Medicine and Cardiac Anesthesiology, Clinic for Cardiovascular Surgery, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.Department of Medical Biochemistry, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.Department of Internal Medicine, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina.Department of Epidemiology and Biostatistics, Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29284896

Citation

Tahto, Ema, et al. "Neutrophil-to-lymphocyte Ratio and Its Relation With Markers of Inflammation and Myocardial Necrosis in Patients With Acute Coronary Syndrome." Medical Archives (Sarajevo, Bosnia and Herzegovina), vol. 71, no. 5, 2017, pp. 312-315.
Tahto E, Jadric R, Pojskic L, et al. Neutrophil-to-lymphocyte Ratio and Its Relation with Markers of Inflammation and Myocardial Necrosis in Patients with Acute Coronary Syndrome. Med Arch. 2017;71(5):312-315.
Tahto, E., Jadric, R., Pojskic, L., & Kicic, E. (2017). Neutrophil-to-lymphocyte Ratio and Its Relation with Markers of Inflammation and Myocardial Necrosis in Patients with Acute Coronary Syndrome. Medical Archives (Sarajevo, Bosnia and Herzegovina), 71(5), 312-315. https://doi.org/10.5455/medarh.2017.71.312-315
Tahto E, et al. Neutrophil-to-lymphocyte Ratio and Its Relation With Markers of Inflammation and Myocardial Necrosis in Patients With Acute Coronary Syndrome. Med Arch. 2017;71(5):312-315. PubMed PMID: 29284896.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neutrophil-to-lymphocyte Ratio and Its Relation with Markers of Inflammation and Myocardial Necrosis in Patients with Acute Coronary Syndrome. AU - Tahto,Ema, AU - Jadric,Radivoj, AU - Pojskic,Lamija, AU - Kicic,Esmeralda, PY - 2017/12/30/entrez PY - 2017/12/30/pubmed PY - 2018/9/18/medline KW - acute coronary syndrome KW - inflammation KW - neutrophil-to-lymphocyte ratio SP - 312 EP - 315 JF - Medical archives (Sarajevo, Bosnia and Herzegovina) JO - Med Arch VL - 71 IS - 5 N2 - Introduction: Inflammation plays an important role in atherosclerosis which is the primary cause of acute coronary syndrome (ACS) that encompasses acute myocardial infarction (AMI) and unstable angina (UA). Objective: To investigate and characterize white blood cells (WBC) count, differential blood count in peripheral blood and neutrophil to lymphocyte ratio (NLR) in patients by the type of ACS. Patients and methods: The cross-sectional study included 100 patients with ACS (50 males, 50 females), aged 41 to 91 years, classified into two groups: AMI group (n=50) and UA group (n=50). Patients were hospitalized at the Clinic for Heart Diseases, University Clinical Center of Sarajevo. From patients' medical histories the following data were obtained: WBC, neutrophil, eosinophil and basophil granulocytes count, monocyte and lymphocyte count, levels of high sensitive troponin I (hsTnI), creatine kinase MB (CK-MB) and C-reactive protein (CRP). The results were analyzed using software package SPSS, version 19.0. Results: Average WBC count, neutrophil granulocytes, and monocytes were significantly higher in AMI group than in UA group (p = 0.001, p < 0.0005, p = 0.03, respectively). Eosinophil count was significantly lower in patients with AMI (p = 0.022). NLR was significantly higher in AMI group in relation to patients with UA (p = 0.001). Significantly higher values of hsTnI and CK-MB were established in patients with AMI. NLR correlated significantly positive with the values of hsTnI, CK-MB, CRP, WBC and neutrophil count, and significantly negative with lymphocyte count. Conclusion: Average values of NLR were significantly higher in patients with AMI in relation to patients with UA, indicating the importance of this inflammatory marker in discrimination of clinical forms of ACS. A positive correlation was established between NLR and markers of myocardial necrosis, and between NLR and CRP, indicating the importance of NLR in the assessment of the extent of the myocardial lesion and in inflammation intensity assessment in ACS. SN - 0350-199X UR - https://www.unboundmedicine.com/medline/citation/29284896/Neutrophil_to_lymphocyte_Ratio_and_Its_Relation_with_Markers_of_Inflammation_and_Myocardial_Necrosis_in_Patients_with_Acute_Coronary_Syndrome_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/29284896/ DB - PRIME DP - Unbound Medicine ER -