Lab Test Ratio Predicts Risk Among Coronary Patients

Neutrophil/lymphocyte ratio independently predicts in-hospital, six-month mortality rates

MONDAY, Sept. 15 (HealthDay News) -- The neutrophil/lymphocyte ratio (NLR) is a comparatively inexpensive marker of inflammation that identifies high-risk patients and may allow for risk stratification of patients with acute coronary syndromes, according to a report in the Sept. 15 issue of the American Journal of Cardiology.

Umesh U. Tamhane, M.D., of the University of Michigan in Ann Arbor, and colleagues used the NLR to predict in-hospital and six-month mortality among 2,833 patients admitted to the University of Michigan Health System with diagnoses of acute coronary syndromes. Multivariate logistic regression modeling was used to estimate the association of NLR with in-hospital and six-month mortality after adjustment for co-morbid conditions using the Global Registry of Acute Coronary Events (GRACE) risk profile.

Overall, 564 and 2,269 patients were diagnosed with ST-segment elevation myocardial infarctions and non-ST-segment elevation acute coronary syndrome, respectively, the investigators found. Tertile 3 patients (greater NLRs) had significantly greater in-hospital (8.5 versus 1.8 percent) and six-month (11.5 versus 2.5 percent) mortality compared to tertile 1 patients, the report indicates. After adjusting for the GRACE risk profile, tertile 3 patients were 2.04 times more likely to experience an in-hospital death and 3.88 times more likely to die at six months.

"The principal findings of our study are that NLR is an independent predictor of in-hospital and six-month mortality in patients with acute coronary syndrome," the authors write. "Patients with higher NLRs showed increased mortality in each tertile of GRACE risk profile, thus providing an additional level of risk stratification in patients with acute coronary syndromes."

The study authors received partial support from an unrestricted grant from Sanofi-Aventis to perform the study.

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