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Prognostic Value of Neutrophil to Lymphocyte Ratio for In-hospital Mortality in Elderly Patients with Acute Myocardial Infarction

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Summary

Coronary artery disease (CAD) is a multifactorial disease in which inflammation plays a central role. This study aimed to investigate the association of inflammatory markers such as the neutrophil to lymphocyte ratio (NLR), the Global Registry of Acute Coronary Events (GRACE) score with in-hospital mortality of elderly patients with acute myocardial infarction (AMI) in an attempt to explore the prognostic value of these indices for elderly AMI patients. One thousand consecutive CAD patients were divided into two groups based on age 60. The laboratory and clinical characteristics were assessed retrospectively by reviewing the medical records. The NLR and GRACE score were calculated. In the elderly (≥60 years), patients with non-ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI) had significantly higher NLR than did those with unstable angina (UA) and stable angina pectoris (SAP) (P<0.01). The NLR was considerably elevated in older AMI patients compared with their younger counterparts (<60 years) (P<0.05). In elderly AMI patients, the NLR was considerably higher in the high-risk group than in both the low-risk and medium-risk groups based on the GRACE score (P<0.05 and P<0.01, respectively), and the NLR was positively correlated with the GRACE score (r=0.322, P<0.001). Either the NLR level or the GRACE score was significantly higher in the death group than in the surviving group (P<0.05). By curve receiver operator characteristic curve (ROC) analysis, the optimal cut-off levels of 9.41 for NLR and 174 for GRACE score predicted in-hospital death [ROC area under the curve (AUC) 0.771 and 0.787, respectively, P<0.001]. It was concluded that an elevated NLR is a potential predictor of in-hospital mortality in elderly patients with AMI.

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Author notes

  1. Both authors contributed equally to this study.

Authors and Affiliations

  1. Department of Geriatrics, Huazhong University of Science and Technology, Wuhan, 430022, China

    Tang-meng Guo, Bei Cheng, Li Ke, Si-ming Guan, Ben-ling Qi, Wen-zhu Li & Bin Yang

  2. Institute of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Tang-meng Guo, Bei Cheng, Li Ke, Si-ming Guan, Ben-ling Qi, Wen-zhu Li & Bin Yang

Authors
  1. Tang-meng Guo
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  2. Bei Cheng
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  3. Li Ke
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  4. Si-ming Guan
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  5. Ben-ling Qi
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  6. Wen-zhu Li
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  7. Bin Yang
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Corresponding author

Correspondence to Li Ke.

Additional information

This project was supported by a grant from Hubei Natural Science Foundation of China (No. 2013CKB011).

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Guo, Tm., Cheng, B., Ke, L. et al. Prognostic Value of Neutrophil to Lymphocyte Ratio for In-hospital Mortality in Elderly Patients with Acute Myocardial Infarction. CURR MED SCI 38, 354–359 (2018). https://doi.org/10.1007/s11596-018-1887-0

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  • DOI: https://doi.org/10.1007/s11596-018-1887-0

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