Ali Raza, Shahid Hameed, Abdul Rehman Abid, Muhammad Imran Farooq, Naeem Asghar, Waqar Hassan.
In-Hospital outcome of acute coronary syndromes with increased Neutrophil to Lymphocyte Ratio.
J Cardiovascular Dis Dec ;10(3):65-9.

Objectives: To compare the outcome between patients with acute coronary syndromes (ACS) with normal vs. increased neutrophil to lymphocyte ratio (NLR). Materials and methods: This Cohort study was conducted at the Department of Cardiology, Punjab Institute of Cardiology, Lahore from December 2009 to May 2010. Cases were selected in the Emergency Department. All patients were explained the purpose and procedure of study and any risk involved was addressed in Emergency Department. Informed consent was taken. Patients of either sex, of age 30 to 70 years, presenting within 24 hours of first event of ACS were included. Patients with evidence of pneumonia, urinary tract infection, prior history of stroke and acute pericarditis were excluded from the study. Investigations including electrocardiography (ECG) and serum Troponin T for ACS, complete blood count for NLR were recorded. Patients were followed for in hospital mortality or discharge from the hospital. Results: In the study group, patients of ACS were young with mean age of 52.8±7.45 years. There were 68% male and 32% female patients in both groups. 40% patients were diabetic in Group I and 29.3% in Group II. 9.3% patients died in Group I and 2.7% in Group II with statistically significant result and p<0.015. However mortality difference in diabetics and non-diabetics (6.7% vs 5.6%, p=0.698), male and female (5.9% vs 6.3%, p=0.9) was not significant. Similarly patients of 30-55 years vs 56-70 years had a mortality of 5.9% vs 6.3%, p=0.9. So result was not statistically significant. Conclusion: Patients with acute coronary syndrome with increased neutrophil to lymphocyte ratio (NLR) have significantly increased in-hospital mortality than those with normal NLR.

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