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01.06.2015 | e-Herz: Original article

Neutrophil–lymphocyte ratio may predict in-hospital mortality in patients with acute type A aortic dissection

verfasst von: S. Karakoyun, MD, M.O. Gürsoy, T. Akgün, L. Öcal, M. Kalçık, M. Yesin, E. Erdoğan, S. Külahçıoğlu, R.B. Bakal, C. Köksal, M. Yıldız, M. Özkan

Erschienen in: Herz | Ausgabe 4/2015

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Abstract

Introduction

Inflammation has been reported to be associated with aortic dissection (AD), from the development to the prognosis of AD. In this study we aimed to find the role of the neutrophil-lymphocyte ratio (NLR) in the prediction of clinical events in patients with acute AD type A.

Patients and methods

The study comprised 37 patients who were hospitalized at our center between 2009 and 2013 with the diagnosis of acute AD type A.

Results

The mean NLR was significantly higher in patients with pericardial effusion than those without effusion (15.6 ± 11.4 vs. 7.5 ± 4.8, p = 0.005). An NLR value > 8.51 yielded an area under the curve (AUC) value of 0.829 [95 % confidence interval (CI) 0.674–0.984, p = 0.004], which demonstrated a sensitivity of 77 % and specificity of 74 % for the prediction of mortality.

Conclusions

The novel inflammatory marker NLR could be used to predict pericardial effusion and in-hospital mortality in patients with acute AD type A.

Nienaber CA, Eagle KA (2003) Aortic dissection: new frontiers in diagnosis and management: part I: from etiology to diagnostic strategies. Circulation 108:628–635PubMedCrossRef

Luo F, Zhou XL, Li JJ, Hui RT (2009) Inflammatory response is associated with aortic dissection. Ageing Res Rev 8:31–35PubMedCrossRef

Suzuki T, Katoh H, Nagai R (1999) Biochemical diagnosis of aortic dissection: from bench to bedside. Jpn Heart J 40:527–534PubMedCrossRef

Najjar SS, Scuteri A, Lakatta EG (2005) Arterial aging: is it an immutable cardiovascular risk factor? Hypertension 46:454–462PubMedCrossRef

Isselbacher EM (2008) Diseases of the aorta. In: Libby P, Bonow R, Mann D, Zipes D (eds) Braunwald’s heart disease: a textbook of cardiovascular medicine, 8th edn. Elsevier Saunders, Philadelphia, p 1457e89

Allaire E, Schneider F, Saucy F et al (2009) New insight in aetiopathogenesis of aortic diseases. Eur J Vasc Endovasc Surg 37:531e7CrossRef

He R, Guo DC, Estrera AL et al (2006) Characterization of the inflammatory and apoptotic cells in the aortas of patients with ascending thoracic aortic aneurysms and dissections. J Thorac Cardiovasc Surg 131:671–678PubMedCrossRef

Li JJ, Fang CH (2004) C-reactive protein is not only an inflammatory marker but also a direct cause of cardiovascular diseases. Med Hypotheses 62:499–506PubMedCrossRef

Papa A, Emdin M, Passino C et al (2008) Predictive value of elevated neutrophil-lymphocyte ratio on cardiac mortality in patients with stable coronary artery disease. Clin Chim Acta 395:27–31PubMedCrossRef

10.

Shen XH, Chen Q, Shi Y, Li HW (2010) Association of neutrophil/lymphocyte ratio with long-term mortality after ST elevation myocardial infarction treated with primary percutaneous coronary intervention. Chin Med J (Engl) 123:3438–3443

11.

Tamhane UU, Aneja S, Montgomery D et al (2008) Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 102:653–657PubMedCrossRef

12.

Hagan PG, Nienaber CA, Isselbacher EM et al (2000) The International Registry of Acute AD (IRAD): new insights into an old disease. JAMA 283:897–903PubMedCrossRef

13.

Imtiaz F, Shafique K, Mirza SS et al (2012) Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. Int Arch Med 5:2PubMedCentralPubMedCrossRef

14.

Folsom AR, Wu KK, Rosamond WD et al (1997) Prospective study of hemostatic factors and incidence of coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) Study. Circulation 96:1102–1108PubMedCrossRef

15.

Kuehl H, Eggebrecht H, Boes T et al (2008) Detection of inflammation in patients with acute aortic syndrome: comparison of FDG-PET/CT imaging and serological markers of inflammation. Heart 94:1472–1477PubMedCrossRef

16.

Reeps C, Essler M, Pelisek J et al (2008) Increased 18F-fluorodeoxyglucose uptake in abdominal aortic aneurysms in positron emission/computed tomography is associated with inflammation, aortic wall instability, and acute symptoms. J Vasc Surg 48:417–423 (discussion 424). doi:10.1016/j.jvs.2008.03.059PubMedCrossRef

17.

Isselbacher EM (2007) Epidemiology of thoracic aortic aneurysms, aortic dissection, intramural hematoma, and penetrating atherosclerotic ulcers. In: Baliga RR, Nienaber CA, Isselbacher EM, Eagle KA (eds) Aortic dissection and related syndromes. Springer Science, New York, p 3e15

18.

Schillinger M, Domanovits H, Bayegan K et al (2002) C-reactive protein and mortality in patients with acute aortic disease. Intensive Care Med 28:740–745PubMedCrossRef

19.

Wen D, Wu HY, Jiang XJ et al (2011) Role of plasma C-reactive protein and white blood cell count in predicting in-hospital clinical events of acute type A aortic dissection. Chin Med J (Engl) 124:2678–2682

20.

Sbarouni E, Georgiadou P, Marathias A et al (2007) D-dimer and BNP levels in acute aortic dissection. Int J Cardiol 122:170–172PubMedCrossRef

21.

Weber T, Hogler S, Auer J et al (2003) D-dimer in acute aortic dissection. Chest 123:1375–1378PubMedCrossRef

22.

Eggebrecht H, Naber CK, Bruch C et al (2004) Value of plasma fibrin D-dimer for detection of acute aortic dissection. J Am Coll Cardiol 44:804–809PubMedCrossRef

23.

Hotchkiss RS, Karl IE (2003) The pathophysiology and treatment of sepsis. N Engl J Med 348:138–150PubMedCrossRef

24.

Bhutta H, Agha R, Wong J et al (2011) Neutrophil-lymphocyte ratio predicts medium-term survival following elective major vascular surgery: a cross-sectional study. Vasc Endovascular Surg 45:227–231. doi:10.1177/1538574410396590PubMedCrossRef

25.

Horne BD, Anderson JL, John JM et al (2005) Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol 45:1638–1643PubMedCrossRef

26.

Sarraf KM, Belcher E, Raevsky E et al (2009) Neutrophil/lymphocyte ratio and its association with survival after complete resection in non-small cell lung cancer. J Thorac Cardiovasc Surg 137:425–428PubMedCrossRef

27.

Yamanaka T, Matsumoto S, Teramukai S et al (2007) The baseline ratio of neutrophils to lymphocytes is associated with patient prognosis in advanced gastric cancer. Oncology 73:215–220PubMedCrossRef

28.

Gomez D, Farid S, Malik HZ et al (2008) Preoperative neutrophil-to-lymphocyte ratio as a prognostic predictor after curative resection for hepatocellular carcinoma. World J Surg 32:1757–1762PubMedCrossRef

29.

Walsh SR, Cook EJ, Goulder F et al (2005) Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol 91:181–184PubMedCrossRef

30.

Cho H, Hur HW, Kim SW et al (2009) Pre-treatment neutrophil to lymphocyte ratio is elevated in epithelial ovarian cancer and predicts survival after treatment. Cancer Immunol Immunother 58:15–23PubMedCrossRef

31.

Tian N, Penman AD, Mawson AR et al (2010) Association between circulating specific leukocyte types and blood pressure: the atherosclerosis risk in communities (ARIC) study. J Am Soc Hypertens 4:272–283PubMedCentralPubMedCrossRef

Titel: Neutrophil–lymphocyte ratio may predict in-hospital mortality in patients with acute type A aortic dissection
verfasst von: S. Karakoyun, MD
M.O. Gürsoy
T. Akgün
L. Öcal
M. Kalçık
M. Yesin
E. Erdoğan
S. Külahçıoğlu
R.B. Bakal
C. Köksal
M. Yıldız
M. Özkan
Publikationsdatum: 01.06.2015
Verlag: Urban & Vogel
Erschienen in: Herz / Ausgabe 4/2015
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI: https://doi.org/10.1007/s00059-014-4121-2

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Abstract

Introduction

Patients and methods

Results

Conclusions

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