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It is well known that inflammation plays a crucial role in acute coronary syndrome. However, the usefulness of inflammatory cells pattern such as neutrophil-to-lymphocyte ratio (NLR) in predicting coronary reperfusion in patients with ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI) has not been inadequately evaluated. Thus, the aim of the present study was to investigate the association between NLR and coronary reperfusion in STEMI patients undergoing primary PCI.
A total of 135 consecutive patients with a diagnosis of STEMI who underwent primary PCI were included in this prospective study between January 2014 and May 2015. The coronary reperfusion of infarct-related artery was evaluated using the recorded PCI procedures by corrected TIMI frame counts (cTFC) values. A value of >40 for the cTFC was considered as an index of insufficient coronary reperfusion, and the patients were divided into two groups: sufficient coronary reperfusion group (cTFC≦40, n=94) and insufficient coronary reperfusion group (cTFC>40, n=41). The white blood cell subtypes and counts were determined in the blood samples obtained before primary PCI. The correlation between NLR and coronary reperfusion of infarct-related artery was analyzed.
There was no significant difference in the baseline characteristics between the two groups. The NLR was significantly greater in insufficient coronary reperfusion group than that in sufficient coronary reperfusion group (9.6 ± 7.2 versus 7.1 ± 4.7, p=0.04). In multivariate analyses, a high NLR was found to be an independent predictor of insufficient coronary reperfusion (odds ratio 1.08, 95% confidence interval 1.01-1.15; p=0.019).
The pre-procedural high NLR may be independently associated with insufficient coronary reperfusion in STEMI patients undergoing primary PCI.