Author + information
- Hocheol Shin1,
- Jae-Sik Jang2,
- Han-Young Jin3,
- Jeong-sook Seo4,
- Tae-Hyun Yang5,
- Dae-Kyeong Kim6,
- Dong-Soo Kim7,
- Yun Seok Song8,
- Pil Sang Song9,
- Dong-Kie Kim10 and
- Doo-Il Kim11
- 1Inje University Pusan Paik Hospital, Pusan, Korea, Republic of
- 2Saint-Luke's Hospital, Kansas City, Korea, Republic of
- 3Busan paik hospital, Busan, Korea, Republic of
- 4Unknown, Seoul, Korea, Republic of
- 5St. Paul Hospital, University of British Colu, Vancouver, British Columbia, Canada
- 6Busan Paik Hospital, Inje University College of Medicine
- 7Busan Paik Hospital, Inje University College of Medicine
- 8Haeundae Paik Hospital, Busan, Korea, Republic of
- 9INJE, Busan, Korea, Republic of
- 10Inje University Haeundae Paik Hospital, Busan, Korea, Republic of
- 11Inje University Haeundae Paik Hospital
Both neutrophil to lymphocyte ratio (NLR) and C-reactive protein (CRP) are biomarkers associated with poor prognosis of patients with acute myocardial infarction (AMI). However, the combined usefulness of NLR and CRP in predicting adverse outcomes has not been investigated.
We analyzed 381 consecutive AMI patients who underwent percutaneous coronary intervention (PCI) from January 2012 to January 2014. The endpoints were, all-cause mortality, recurrent myocardial infarction (MI), stent thrombosis, further revascularization, stroke and major adverse cardiac and cerebrovascular events (MACCE) at 24 months’ follow-up. Included patients were divided into 4 groups according to the optimal cut-off values for NLR and CRP predicting mortality.
Patients with high NLR and high CRP (NLR>6.30 and CRP0.76, n = 25) had significantly greater risk of all-cause death (44.0% vs. 6.4% vs. 13.1% vs. 13%, respectively, p <0.001) as compared to the other groups and they were at highest risk of MACCE among the 4 groups without significant increase in the risk of recurrent MI, stent thrombosis and stroke. Kaplan-Meier analysis revealed significantly lower survival in patients with high NLR and high CRP. On Cox multivariate analysis, high NLR and high CRP (hazard ratio 7.86, 95% confidence interval 2.81 to 22.01, p < 0.001) was the independent predictor of all-cause death.
Elevated levels of both NLR and CRP are associated with increased long-term mortality in AMI patients who have undergone PCI.
CORONARY: PCI Outcomes