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Meta-Analysis
. 2018 Nov 11:2018:2703518.
doi: 10.1155/2018/2703518. eCollection 2018.

Neutrophil Lymphocyte Ratio and Cardiovascular Disease Risk: A Systematic Review and Meta-Analysis

Teeranan Angkananard  1   2 , Thunyarat Anothaisintawee  3 , Mark McEvoy  4 , John Attia  4 , Ammarin Thakkinstian  1
Affiliations
Meta-Analysis

Neutrophil Lymphocyte Ratio and Cardiovascular Disease Risk: A Systematic Review and Meta-Analysis

Teeranan Angkananard et al. Biomed Res Int. .

Abstract

Objective: This systematic review aimed to measure the association between neutrophil lymphocyte ratio (NLR) and cardiovascular disease (CVD) risk.

Methods: Relevant studies were identified from Medline and Scopus databases. Observational studies with NLR as a study factor were eligible for review. The outcomes of interest were any type of CVD including acute coronary syndrome, coronary artery disease, stroke, or a composite of these cardiovascular events. Mean differences in NLR between CVD and non-CVD patients were pooled using unstandardized mean difference (USMD). Odds ratios of CVD between high and low NLR groups were pooled using a random effects model.

Results: Thirty-eight studies (n=76,002) were included. High NLR was significantly associated with the risks of CAD, ACS, stroke, and composite cardiovascular events with pooled ORs of 1.62 (95% CI: 1.38-1.91), 1.64 (95% CI: 1.30, 2.05), 2.36 (95% CI: 1.44, 2.89), and 3.86 (95% CI: 1.73, 8.64), respectively. In addition, mean NLRs in CAD, ACS, and stroke patients were significantly higher than in control groups.

Conclusion: High NLR was associated with CAD, ACS, stroke, and composite cardiovascular events. Therefore, NLR may be a useful CVD biomarker.

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Figures

Figure 1
Figure 1
Flow chart of study selection.
Figure 2
Figure 2
Summary of pooled effect sizes of neutrophil lymphocyte ratio on cardiovascular risk.
See this image and copyright information in PMC

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