Study of Neutrophil-Lymphocyte Ratio in Patients of Myocardial Infarction

ABSTRACT

Background: Coronary artery disease (CAD) continues to be a major cause of morbidity and mortality in both Men and women not only in developed countries but also in developing countries. Objective: To study the value of neutrophil lymphocyte ratio in patients of acute myocardial infarction in immediate post-infarct period and correlation between the value and the development of complications and mortality during hospital Stay in patients of AMI. Materials and methods: Patients of acute myocardial infarction admitted in ICCU of a Civil hospital were included in the present study. Acute Myocardial Infarction was diagnosed in patients with ischemic chest pain by presence of ST- segment elevation of >1mm with or without T wave inversion and Q wave in more than two consecutive limb or chest leads in standard 12 lead ECG. Hemoglobin level, Total WBC count and differential count of patients were obtained by Abacus-3 hematology analyzer (Hungary). Results: We found strong association of Neutrophil Lymphocyte ratio with Complications (p=0.004). Mean admission N L ratio in patients with Complicated MI (3.9+/-1) was found to be significantly higher than the mean level in patients with uncomplicated MI (3.4+/-0.9). Rate of complications among patients in range of 0 to 2 N L ratio was found to be 12.5%, in range of 2 to 4 it was 33.33% while with N L ratio above 4 almost 75% of patients had complications. We also found strong association of neutrophil Lymphocyte ratio with death, mean admission N L ratio in patients who died (4.1+/-0.5) was found to be significantly higher than the mean level in patients who survived (3.6+/-1). (p=0.006). Mortality among patients in range of 0 to 2 N L ratio was nil, while in range of 2.1 to 4 it was 2.32% and in range above 4 was 50%. Conclusion: From our study, we draw a conclusion that N L ratio at the time of hospital do have a direct correlation with development of complication and/or mortality in early post-infarct period. We Haresh Panchal. Study of Neutrophil-Lymphocyte Ratio in Patients of Myocardial Infarction. IAIM, 2019; 6(5) 12-15. Page 13 also found that these markers are important not only for diagnosis but also have prognostic values and help in risk stratification and decision making regarding further early therapeutic intervention.