NEUTROPHIL TO LYMPHOCYTE RATIO AS MORTALITY PREDICTOR IN ACUTE CORONARY SYNDROME PATIENTS

Abstract

Introduction: Inflammation plays important role in atherosclerosis which is the primary mechanism in
acute coronary syndrome (ACS). Neutrophil to lymphocyte ratio (NLR) as an indication of systemic
inflammation has been researched to be associated with morbidity and mortality in ACS. There are little
data available about the association between NLR, levels with GRACE and TIMI risk score. Purpose of
this study was to determine the association of NLR with GRACE and TIMI score in ACS patients.
Methodology. A total of 1000 ACS patients were recruited into this study retrospectively from patients that
admitted to Cardiology Department at Dustira Army Hospital. Patient assessment and medical record
review were performed from January 2019 to January 2020. Results. The GRACE risk score was
significantly higher in the group with high NLR value compared to those with moderate and low NLR
value respectively 155 (132.2-178), 134 (115-156), 125 (107.5-144.25), p<0.001). Similarly, TIMI score
for UAP, NSTEMI and STEMI significantly higher in the group with high NLR value compared to those
with moderate and low NLR value respectively (3 (3-4), 3 (3-4), 3 (3-3), p<0.001), (5 (4-5), 4 (4-5), 4.5 (4-
5), p<0.001) and (6 (5-7), 6 (5-6), 6 (5.5-6), p<0.001). Moreover, both GRACE (r=0,402, p<0.000) and
TIMI (r=0.221, r=0.234, r=0.295, in UAP, NSTEMI, and STEMI respectively, p<0.000) score showed a
significant positive correlation with NLR respectively. Conclusions. NLR is convenient, inexpensive and
reproducible biomarker for ACS prognosis.