Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug 12:14:4459-4468.
doi: 10.2147/IJGM.S325907. eCollection 2021.

Association of Lymphocyte to Monocyte Ratio and Risk of in-Hospital Mortality in Patients with Cardiogenic Shock: A Propensity Score Matching Study

Zhengwei Zhang  1 , Qionghua Hu  1 , Tianyang Hu  2
Affiliations

Association of Lymphocyte to Monocyte Ratio and Risk of in-Hospital Mortality in Patients with Cardiogenic Shock: A Propensity Score Matching Study

Zhengwei Zhang et al. Int J Gen Med. .

Abstract

Background: Lymphocyte to monocyte ratio (LMR) has been long implicated in the prediction of many inflammatory-related diseases. However, the possible value as prognostic marker of LMR have not been evaluated in cardiogenic shock (CS) patients. The aim of the study was to assess the relationship between LMR on admission and in-hospital mortality in CS patients.

Methods: Data on patients diagnosed with CS were extracted from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. We performed a single-institution, retrospective study of 1487 CS patients and determined the optimal cut-off for LMR by X-tile software. Propensity score matching (PSM) and inverse probabilities of treatment weighting (IPTW) were conducted to control confounders. Cox proportional hazards model was performed to evaluate the relationship between LMR and in-hospital mortality. Kaplan-Meier curves and receiver operating characteristics (ROC) analysis were applied to assess the prognostic value of LMR.

Results: The optimal cut-off value for LMR was 0.9. Cox proportional hazards model demonstrated that lower LMR (< 0.9) was independently associated with in-hospital mortality with hazard ratio (HR) of 1.40 (1.12-1.74, P = 0.003). The results were consistent with survival analyses (P < 0.001, Log rank test). Adding LMR< 0.9 to the sequential organ failure assessment (SOFA) score improved discrimination and risk stratification for in-hospital mortality.

Conclusion: Lower level of LMR is related to higher risk of in-hospital mortality of patients with CS. As an easily available biomarker, LMR can independently predict the in-hospital mortality in CS patients.

Keywords: CS; LMR; cardiogenic shock; lymphocyte to monocyte ratio; mortality.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
The flow chart of the included population.
Figure 2
Figure 2
Overall survival of high-LMR and low-LMR groups. Kaplan–Meier curve (A) before and (B) after PSM.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Kolte D, Khera S, Aronow W, et al. Trends in incidence, management, and outcomes of cardiogenic shock complicating ST-elevation myocardial infarction in the United States. J Am Heart Assoc. 2014;3(1):e000590. doi:10.1161/JAHA.113.000590 - DOI - PMC - PubMed
    1. Lim H, Howell N. Cardiogenic shock due to end-stage heart failure and acute myocardial infarction. Shock. 2018;50(2):167–172. doi:10.1097/SHK.0000000000001052 - DOI - PubMed
    1. Mebazaa A, Combes A, van Diepen S, et al. Management of cardiogenic shock complicating myocardial infarction. Intensive Care Med. 2018;44(6):760–773. doi:10.1007/s00134-018-5214-9 - DOI - PubMed
    1. De Luca L, Olivari Z, Farina A, et al. Temporal trends in the epidemiology, management, and outcome of patients with cardiogenic shock complicating acute coronary syndromes. Eur J Heart Fail. 2015;17(11):1124–1132. doi:10.1002/ejhf.339 - DOI - PubMed
    1. Thom T, Haase N, Rosamund W, et al. Heart disease and stroke statistics-2006 update: a report from the American Heart Association statistics committee and stroke statistics subcommittee. Circulation. 2006;113:e85–e151. doi:10.1161/CIRCULATIONAHA.105.171600 - DOI - PubMed