Neutrophil to lymphocyte (N/L) ratio associated with adverse outcomes in STEMI patients treated with transradial primary angioplasty

Objective: Inflammation is a well-known factor in atherosclerosis. Neutrophil/lymphocyte (N/L) ratio reflects the systemic inflammatory status. The prognostic relevance of the N/L ratio in the transfemoral approach with percutaneous coronary intervention (PCI) has been well established in ST-segment elevation myocardial infarction (STEMI). Our goal herein was to define the N/L ratio as a prognostic index and to determine effect on STEMI patients enduring transradial PCI. Methods: Retrospectively, STEMI patients (n=329) that have already undergone primary PCI with a transradial approach (TRA) were included in our study. Based on the determined levels of the N/L ratio, subjects were grouped into three categories. Upon consenting, blood was collected from each patient followed by transthoracic echocardiography and PCI. Results : Post- procedural patients were followed-up for an average of 1.5 years over a 3.5 year period. Cardiovascular mortality, non-fatal myocardial infarction, and in-stent thrombosis trended positively with an increase in the in-hospital period (p<0.0001, p<0.0001, p=0.005, respectively). With respect to the follow-up of long-term results, in-stent thrombosis and cardiovascular mortality tended to be higher within the groups (p<0.001, p=0.046, respectively). As a prognostic index, the N/L ratio strongly predicted the long-term MACE (OR 3.20, 95% CI 1.60-6.40; p=0.001) and in-hospital major adverse cardiac events (MACE) (OR 1.20, 95% CI 1.10-1.30; p=0.003) in STEMI patients enduring PCI with TRA. Conclusion : The N/L ratio was a useful prognostic index for long-term and in-hospital outcomes in STEMI patients enduring PCI with the TRA.