Predictive value of neutrophil/lymphocyte ratio in predicting complications after non st elevation myocardial infraction

A Cross sectional study conducted in Cardiology Unit, Hayatabad Medical Complex from August 2011 to February 2012. In a total of 250 patients with non ST elevation MI were enrolled in study. Neutrophil to lymphocyte ratio [NLR] was determined. Those with high NLR were followed over two week period to detect in hospital mortality; Atrial Fibrillation and ST segment Deviation. Association of cellular response with the incidence of post-MI mortality/complications was assessed by multiple logistic regression analyses. There were 250 patients comprising of 154 [61.60%] males and 96 [38.40%] females. The overall mean age was 51.57 +/- 12.5 years. The frequency of high neutrophil to lymphocyte ratio was present in 78 [31.20%] patients. The In hospital mortality and atrial fibrillation rate was in 10.26% and 11.54% cases respectively while ST segment deviation was in 57.69% patients. Patients with Non ST Segment elevation Myocardial Infarction with high Neutrophil to lymphocyte ratio, is a good predictor of In hospital mortality, atrial fibrillation and ST segment deviation. Thus a single CBC analysis may help to identify Non- STEMI patients at risk for mortality and complications.

Clinical profile of patients with normal coronary angiogram

To observe the clinical and bio-chemical profile of patients having normal coronary angiogram following an abnormal stress test. This was a single center retrospective, descriptive study. Coronary angiograms done from July 2009 to December 2011 were retrieved and reviewed for normal coronary arteries. Clinical and bio-chemical profile of the patients having normal coronary angiogram was retrieved from hospital record. Patients, whose computerized data could not be retrieved from department database, were excluded from the study. Out of 8425 angiograms reviewed, 816[9.7%] were having normal coronary arteries. Mean age was 4 +/- 27.4 years. Females were 66.7%. Clinical and biochemical profile for normal coronary angiograms was as follows: smokers 59%, family history of premature coronary artery disease 41%, hyperlipidemia18.5% and hypertension 14%. Diabetes was present only in 2.1%. Among females: 11% were current users of oral contraceptives pills, 3.4% were post menopausal and 0.87% pregnant. Mean BMI was 25.4 +/- 5.2 and total cholesterol and triglyceride were 278 +/- 31mg/dl and 180 +/- 28mg/dl respectively. Normal coronary angiogram is infrequently observed in catheterization laboratories and mostly found in younger to middle aged females. Smoking is very common in such patients. Hyperlipidemia, hypertension, diabetes mellitus are not frequently present in these patients.