Correlation Between Neutrophil-to-Lymphocyte Ratio and Left Ventricular Ejection Fraction in ST-Elevation Myocardial Infarction Patients Receiving Primary Percutaneous Coronary Intervention

Abstract

Background: ST-elevation myocardial infarction (STEMI) is a very serious type of heart attack during which one of the heart's major arteries (one of the arteries that supplies oxygen and nutrient-rich blood to the heart muscle) is blocked. Furthermore, it is one of the acute coronary syndrome (ACS) spectrum with a high mortality and morbidity rate. Reperfusion therapy in the form of primary percutaneous coronary intervention (PCI) is currently recommended for STEMI patients, and the total occlusion of coronary vessels during STEMI leads to myocardial dysfunction. The left ventricular ejection fraction (LVEF) is a parameter for determining the ventricular systolic function and is known as a prognostic factor in heart disease. The neutrophil-to-lymphocyte Ratio (NLR), a simple biomarker, has been widely studied as a predictor of major adverse cardiac events in ACS patients and mortality in STEMI patients. In addition, simple biomarkers are needed to stratify the risk of STEMI patients against decreased LVEF post-primary PCI.
Aim and Objective: To investigate the correlation between NLR and LVEF in STEMI patients receiving primary PCI
Method: This is an observational analytical study with a cross-sectional design. A total of 196 STEMI patients receiving primary PCI from August 2019—November 2020 were included in this study. The data were consecutively obtained from SCIENCE (Sardjito Cardiovascular Intensive Care) registry. Furthermore, the data were analyzed using Pearson’s Correlation and Phi Correlation Tests was used to determine the correlation between NLR and LVEF. The NLR cut-off value was obtained from the analysis of the receiver characteristic curve analysis.
Results: There was no significant negative NLR and LVEF correlations in both the overall analysis (r = -0,065; p = 0,362) and in sub-group analysis (r=-0,107; p=0,133) based on the cut-off value of NLR (5,73) and LVEF (50%).
Conclusion: There was no significant negative correlation between NLR and LVEF in STEMI patients receiving primary PCI.
Keywords: Left ventricular ejection fraction; Neutrophil-to-lymphocyte Ratio; primary percutaneous coronary intervention; STEMI