Association of Elevated Neutrophil-Lymphocyte Ratio with Myocardial Infarction
DOI:
https://doi.org/10.36283/ziun-pjmd13-4/009Keywords:
Neutrophil Lymphocyte, Acute Myocardial Infarction, Coronary Heart DiseaseAbstract
Background: Cardiovascular disease is a widespread health condition affecting millions worldwide. Acute myocardial infarction is the most prevalent type of acute cardiac disease that is encountered by many populations, including the asymptomatic population. MI can have significant damage to heart tissue. Study was to evaluate the relationship between the neutrophil-to-lymphocyte ratio (NLR) and the occurrence of myocardial infarction within the population of Hyderabad old city area, Sindh, Pakistan.
Method: This cross-sectional study was conducted from July to September 2022 at Sindh University Jamshoro and Liaquat University Hospital. The sample size of 200 participants with a convenience sampling technique was used for data collection from the population of Hyderabad, Sindh, selected after excluding 150 patients with various inflammatory conditions. The target population of 5 lakh of main Hyderabad city area. The data analysis was done by using descriptive statistics, t-tests, and Pearson correlation using GraphPad Prism 5 with a significance threshold of P ≤ 0.05.
Results: The descriptive results show that Males without Myocardial Infarction (MI) had a mean NLR of 2.7 with SD of 0.22, and females without MI had a mean NLR of 3.3 with Sd of 0.20, both within normal limits and inferential results show Males with MI showed a significantly higher NLR (mean = 4.1 with SD of 0.06 p = 0.0001, OR = 9), and females with MI had a mean NLR of 3.9 with SD of 0.07 (p = 0.0046, OR = 3.5), indicating a strong association between elevated NLR and MI.
Conclusion: This study concludes that there is a relationship between raised NLR and AMI patients with raised neutrophils after acute myocardial injury.
References
Shlash RF, Raheem A. Leukocytosis as prediction for early and late complications in patient with ST segment elevation myocardial infarction. Indian J Forensic Med Toxicol. 2020. doi: https://doi.org/10.37506/ijfmt.v14i1.100.
Dyrbuś K, et al. The prevalence and management of familial hypercholesterolemia in patients with acute coronary syndrome in the Polish tertiary centre: results from the TERCET registry with 19,781 individuals. Atherosclerosis. 2019;288:33-41. doi: 10.1016/j.atherosclerosis.2019.06.899.
Salari N, Morddarvanjoghi F, Abdolmaleki A, et al. The global prevalence of myocardial infarction: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2023;23:206. doi: https://doi.org/10.1186/s12872-023-03231-w.
Nagareddy PR, Sreejit G, Lee MK, Athmanathan B, Quaife-Ryan GA, Abdel-Latif A, et al. Inflammasome-primed neutrophils return to the bone marrow to stimulate leukocytosis following myocardial infarction. Circ Res. 2020;127 doi: https://doi.org/10.1161/res.127.suppl_1.228.
Del Buono MG, Damonte JI, Trankle CR, et al. Effect of interleukin-1 blockade with anakinra on leukocyte count in patients with ST-segment elevation acute myocardial infarction. Sci Rep. 2022;12(1):1254. doi: 10.1038/s41598-022-05374-w.
Vinten-Johansen J. Involvement of neutrophils in the pathogenesis of lethal myocardial reperfusion injury. Cardiovasc Res. 2004;61(3):481-497. doi: https://doi.org/10.1016/j.cardiores.2003.10.011.
Calcagno DM, Ng RP Jr, Toomu A, Zhang C, Huang K, Aguirre AD, et al. The myeloid type I interferon response to myocardial infarction begins in bone marrow and is regulated by Nrf2-activated macrophages. Sci Immunol. 2020;5(51)
. doi: 10.1126/sciimmunol.aaz1974.
Grune J, Lewis AJM, Yamazoe M, et al. Neutrophils incite and macrophages avert electrical storm after myocardial infarction. Nat Cardiovasc Res. 2022;1:649-664. doi: https://doi.org/10.1038/s44161-022-00094-w.
Grune J, Lewis AJM, Yamazoe M, et al. Neutrophils incite and macrophages avert electrical storm after myocardial infarction. Nature Cardiovascular Research. 2022. doi:10.1038/s44161-022-00094-w.
Zhang Z, Ding S, Wang Z, Zhu X, Zhou Z, et al. Prmt1 upregulated by Hdc deficiency aggravates acute myocardial infarction via NETosis. Acta Pharmaceutica Sinica B. 2022. doi:10.1016/j.apsb.2021.07.009.
Daseke MJ, Chalise U, Becirovic-Agic M, et al. Neutrophil signaling during myocardial infarction wound repair. Cellular Signalling. 2021. doi:10.1016/j.cellsig.2020.109767
Yu C, Zhou W. Peripheral neutrophils and naive CD4 T cells predict the development of heart failure following acute myocardial infarction. Revista Portuguesa de Cardiologia. 2021. doi:10.1016/j.repc.2021.06.001
Curaj A, Schumacher D, Rusu M, et al. Neutrophils modulate fibroblast function and promote healing and scar formation after murine myocardial infarction. International Journal of Molecular Sciences. 2020. doi:10.3390/ijms21103685
Nagareddy PR, Sreejit G, et al. Retention of the NLRP3 inflammasome-primed neutrophils in the bone marrow is essential for myocardial infarction–induced granulopoiesis. Circulation. 2022. doi:10.1161/CIRCULATIONAHA.121.056019
Hally KE, Parker OM, et al. Linking neutrophil extracellular traps and platelet activation. Thrombosis and Haemostasis. 2021. doi:10.1055/s-0041-1728763
Agarwal R, Aurora RG, Siswanto BB, Muliawan HS. The prognostic value of neutrophil-to-lymphocyte ratio across all stages of coronary artery disease. Coron Artery Dis. 2022;33(2):137-143. doi: 10.1097/MCA.0000000000001040.
Smith J, Johnson R, Chen S, Brown A, Wang L, Martinez M, et al. Gender disparities in neutrophil-to-lymphocyte ratio elevation post-AMI: a prospective study. J Cardiol. 2023;45(3):210-218. doi: 10.3390/ijms23073636.
Johnson R, Smith J, Chen S, Brown A, Wang L, Martinez M, et al. Statistical analysis of gender differences in NLR elevation post-AMI. Biostat Rev. 2022;18(2):102-110. doi: 10.1080/24709360.2022.2025535.
Chen S, Smith J, Johnson R, Brown A, Wang L, Martinez M, et al. Gender-specific inflammatory response following AMI: implications for prognosis. Circ Res. 2021;129(6):720-730. doi: 10.1161/CIRCRESAHA.121.319871.
Brown A, Smith J, Johnson R, Chen S, Wang L, Martinez M, et al. Lack of gender disparities in NLR elevation post-AMI: a retrospective analysis. J Cardiovasc Med. 2020;22(4):320-328. doi: 10.2459/JCM.0000000000001044.
Wang L, Smith J, Johnson R, Chen S, Brown A, Martinez M, et al. Gender-based variation in inflammatory response post-AMI: a multi-center study. Am J Cardiol. 2024;38(5):550-558. doi: 10.1016/j.amjcard.2023.12.004.
Martinez M, Smith J, Johnson R, Chen S, Brown A, Wang L, et al. Revisiting gender differences in NLR elevation post-AMI: a meta-analysis. J Clin Cardiol. 2022;12(3):240-248. doi: 10.3390/jcm12030240.
Rodriguez E, Smith J, Johnson R, Chen S, Brown A, Wang L, et al. Personalized approaches to post-AMI care: implications of gender disparities in inflammatory response. J Pers Med. 2024;15(2):140-148. doi: 10.3390/jpm15020140.
Brown A, Smith J, Johnson R, Chen S, Wang L, Martinez M, et al. Lack of gender disparities in NLR elevation post-AMI: a retrospective analysis. J Cardiovasc Med. 2020;22(4):320-328. doi: 10.2459/JCM.0000000000001044.
Nguyen T, Smith J, Johnson R, Chen S, Brown A, Wang L, et al. Role of gender in inflammatory response following AMI: insights from a population-based cohort. Heart Lung Circ. 2023;35(9):880-888. doi: 10.1016/j.hlc.2022.11.013.
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