Neutrophil-to-lymphocyte ratio and in-hospital mortality in patients with acute heart failure

Turfan, Murat; ErdoĞan, Ercan; Tasal, Abdurrahman; Vatankulu, Mehmet Akif; Jafarov, Parviz; Sönmez, Osman; Ertaş, Gökhan; Bacaksız, Ahmet; Göktekin, Ömer

doi:10.6061/clinics/2014(03)08

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Sumário

CLINICAL SCIENCES • Clinics 69 (3) • Mar 2014 • https://doi.org/10.6061/clinics/2014(03)08 copy

Neutrophil-to-lymphocyte ratio and in-hospital mortality in patients with acute heart failure

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVES:

Previous studies have demonstrated the role of inflammation in acute heart failure. The neutrophil-to-lymphocyte ratio was found to be a useful inflammatory marker for predicting adverse outcomes. We hypothesized that an elevated neutrophil-to-lymphocyte ratio would be associated with increased mortality in acute heart failure patients.

METHODS:

The study cohort consisted of 167 acute heart failure patients with an ejection fraction <50%. The primary endpoint was in-hospital mortality, and the patients were divided into two groups according to in-hospital mortality.

RESULTS:

In a multivariate regression analysis, including baseline demographic, clinical, and biochemical covariates, the neutrophil to lymphocyte ratio remained an independent predictor of mortality (OR 1.156, 95% CI 1.001 - 1.334, p= 0.048).

CONCLUSION:

In conclusion, an elevated neutrophil-to-lymphocyte ratio seems to be a predictor of short-term mortality in patients with acute heart failure and a reduced left ventricular ejection fraction.

Neutrophil-to-Lymphocyte Ratio; Mortality; Acute Heart Failure

	Group 1	Group 2	p-value
N	15	152
Age	75±8	67±9	0.002
Male (%)	40	62.5	0.079
Ischemic HF (%)	52.3	61.8	0.352
Hypertension (%)	60	57.1	0.531
Diabetes mellitus (%)	53.3	50.7	0.529
Hyperlipidemia (%)	60	36.2	0.065
History of percutaneous intervention (%)	46.7	37.5	0.333
History of coronary artery bypass grafting (%)	20	14.5	0.396
Atrial fibrillation (%)	60	28.9	0.017
NYHA class III or IV	80	73.7	0.428
Use of beta-blockers (%)	33.3	40.1	0.413
Use of ACEI (%)	73.3	65.6	0.384
Use of spironolactone (%)	26.3	33.6	0.411
Use of diuretics (%)	40	39.5	0.587
Ejection fraction (%)	30±6	34±7	0.025
Serum hemoglobin levels (g/dl)	12.5±1.7	12.2±1.8	0.585
Serum Na levels (mmol/l)	132±4	134±5	0.141
Serum creatinine levels (mg/dl)	1.4±0.8	1.2±0.5	0.161
Mean NLR	7.2±4.8	4.8±3	0.007

	OR	95.0% CI	p-value
Age	1.105	1.036-1.1180	0.003
Male	2.500	0.846-1.475	0.583
Hypertension	1.121	0.380-3.306	0.836
DM	1.113	0.384-3.223	0.843
Ischemic HF	0.705	0.243-2.047	0.521
Atrial fibrillation	3.682	1.237-10.960	0.019
NYHA class III or IV	1.429	0.383-5.325	0.387
Use of beta-blockers	0.746	0.243-2.289	0.608
Use of ACEI	1.444	0.438-4.760	0.546
Use of spironolactone	0.720	0.218-4.760	0.590
Use of diuretics	1.022	0.346-3.019	0.968
Serum Na levels	0.918	0.817-1.030	0.144
Serum creatinine levels	1.726	0.794-3.752	0.168
Hemoglobin levels	1.089	0.804-1.475	0.583
Ejection fraction	0.913	0.843-0.991	0.029
NLR	1.181	1.035-1.347	0.013

	OR	95.0% CI	p-value
Age	1.091	1.016 - 1.171	0.016
Atrial fibrillation	2.895	0.886 - 9.456	0.078
Ejection fraction	0.909	0.827 - 0.998	0.046
NLR	1.156	1.001 - 1.334	0.048

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[1] Turfan M wrote the manuscript and selected the patients. ErdoĞan E, Tasal A, Vatankulu MA, Jafarov P and Sönmez O collected the data. Ertaş G performed the statistical analyses. Bacaksız A performed the literature review. Göktekin O was responsible for the final editing.