Association between Neutrophil to Lymphocyte Ratio and Left Ventricle Global Longitudinal Strain in Acute Myocardial Infarctions Patients

Author : A. A. Nursidiq, N. Purwaningtyas, T. Wasyanto
Upload Date : 19-04-2018

Background: Acute myocardial infarction (AMI) is the most severe manifestation of coronary artery disease. High neutrophil to lymphocyte ratio (NLR) is independently associated with lower left ventricular ejection fraction (LVEF), in hospital complications, and higher mortality rates in AMI patients. Global longitudinal strain (GLS) measurement after MI has also demonstrated specific benefit compared with LVEF in evaluation of the extent of post MI left ventricular myocardial injury. The aim of this study was to investigate the association between NLR and left ventricular GLS in AMI patients.

Methods: This was a cross-sectional study on AMI patients who admited to Dr. Moewardi General Hospital with onset ≤24 hours. Blood examination and transthoracic echocardiography were performed to all patients. They were divided into two groups according to result of GLS measurement, GLS>-13.8% and GLS ≤-13.8%. The cut-off value of NLR to predict GLS>-13.8% was determined by ROC curve analysis. Bivariate and multivariate analysis were performed to assess whether high NLR was associated with GLS>-13.8%.

Results: 57 patients were included in this study, there were 24 patients (mean age 56.21±9.43) in GLS ≤-13.8% group and 33 patients (mean age 56.67±8.24) in GLS >-13.8%. NLR was significantly higher in GLS>-13.8% group 6.06 (5.36-6.86) compare with 4.20 (3.49-5.04), in GLS ≤-13.8%, p=0.001. The cut-off value of NLR  was 4.69. The bivariate analysis showed that NLR >4.69 associated with GLS>-13.8%, odds ratio (OR) 2.70 (CI 95% 1.41-5.17, p=0.001). Multivariate analysis shown that higher NLR have more probability to develop GLS >-13.8% with OR 8.53 (CI 95% 2.38-30.60, p<0.001).

Conclusion: There is an association between NLR and left ventricular GLS in AMI  patients. AMI patients with high NLR are more likely to have worse GLS.

KEYWORDS : neutrophil to lymphocyte ratio, global longitudinal strain, acute myocardial infarction.

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