Role of Neutrophil-lymphocyte Ratio as Short- term Outcome Prognostic Indicator Following an Acute ST Segment Elevation Myocardial Infarction-A Prospective Observational Study

Introduction:: The ratio of Neutrophils to Lymphocytes (NLR) has recently arisen as a likely biomarker to forecast clinical outcomes in Ischemic Heart Disease (IHD). The NLR in cases of ST Elevation Myocardial Infarction (STEMI) with respect to survival outcomes and complications is not well established in literature and was evaluated in the present study. Aim: To study the association of NLR with complications and mortality following acute STEMI. Materials and Methods: A short-term prospective observational study was conducted in 102 participants diagnosed with STEMI. The study was conducted at tertiary care hospital from October 2015 to September 2017. Haematological, serological and radiographical findings were obtained and compared between survivors and non survivors. Receiver Operator Curve (ROC) and Area Under the Curve (AUC) analysis were performed to analyse the utility of NLR in predicting mortality and major complications. Results: The mean age of patients was 64.12 +/- 14.82 years and 75.5% of them were male. Non survivors (9.8%) had a greater incidence of cardiogenic shock (p-value <0.00049), pulmonary oedema (p-value <0.01199) and tachyarrhythmia (p-value <0.00049) compared to survivors. The ROC and AUC analysis showed that a higher NLR had a sensitivity of 80% in detecting mortality, 77.78% in detecting cardiogenic shock and 80% in detecting pulmonary oedema. Conclusion: Higher NLR can be a useful prognostic marker for predicting short-term mortality and acute complications following an acute STEMI.