Value of Neutrophil to Lymphocyte Ratio and Its Trajectory in Patients Hospitalized With Acute Heart Failure and Preserved Ejection Fraction
Section snippets
Methods
Using Stanford Translational Research Integrated Database Environment (STRIDE),11 we identified 3,847 adult patients with a diagnostic code of “HFpEF” (ICD-9 code 428.3) between January 2002 and December 2013, in whom CBC data were available on both admission and discharge. HFpEF was diagnosed clinically in the presence of an elevated NT-proBNP level >300 pg/mL or evidence of heart failure with a LVEF >50%. Evidence of heart failure was based on the presence of pulmonary edema on chest X-ray,
Results
Clinical and biological characteristics on admission of the 443 patients included are presented in Tables 1 and 2. Mean age was 77 ± 16 years; 59% were women and the median duration of hospitalization was 5 (3 to 9) days. The GWTG-HF risk score was normally distributed as illustrated in Figure 2 and had a mean value of 41.4 ± 8.3. The median NT-proBNP, available in 271 patients (58.8%), was 2,262 (1,071 to 5,243) pg/mL.
The NLR on admission was skewed to the right with a median value of 6.5 (3.6
Discussion
The main finding of our study is that NLR on admission and absolute NLR trajectory are associated with all-cause mortality in patients with acute HFpEF beyond the well-validated GWTG-HF risk score.
The importance of the NLR in patients with cardiovascular disease was first recognized in patients with ischemic heart disease and myocardial infarction.14,15 Recently, the prognostic value of NLR in patients with heart failure has further been investigated; however, majority of the previously
Disclosures
Dr. Horne is an inventor of complete blood count-based risk scores that Intermountain Healthcare has licensed to CareCentra, and is PI of research grants funded by Intermountain Healthcare's Foundry innovation program, the Intermountain Research and Medical Foundation, CareCentra, GlaxoSmithKline, and AstraZeneca for the development and/or clinical implementation of complete blood count-based clinical decision tools. We also would like to acknowledge the Srinivasan research fund.
Acknowledgment
This work was supported by the Intermountain-Stanford Collaboration Initiative and the Philips Royal Research Grant of Heart Failure with Preserved Ejection Fraction.
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Neutrophils to lymphocytes ratio and psychosis in 22q11.2 deletion syndrome – Clinical and scientific implications
2021, Schizophrenia ResearchCitation Excerpt :In recent years alterations in the ratios between leukocyte sub-populations, primarily the neutrophils to lymphocytes ratio (NLR), were suggested as markers of systemic inflammation and stress (Zahorec, 2001). NLR was validated as a bio-marker and prognostic factor for a variety of medical conditions (Boralkar et al., 2020; Chen et al., 2020; Hwang et al., 2017; Ma et al., 2019; Xin-Ji et al., 2015; Xu et al., 2020). Neutrophils are the main cells of the innate arm of the immune system and lymphocytes are central in the adaptive arm.
Funding: This work was supported by the Intermountain-Stanford Collaboration Initiative and the Philips Royal Research grant of heart failure with preserved ejection fraction.
- 1
KAB and YK contributed equally to this study.