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Review
. 2024 Mar 28;76(1):39.
doi: 10.1186/s43044-024-00469-3.

The value of neutrophil-to-lymphocyte ratio in predicting severity of coronary involvement and long-term outcome of percutaneous coronary intervention in patients with acute coronary syndrome: a systematic review and meta-analysis

Farzad Shahsanaei  1 , Shahin Abbaszadeh  1 , Soudabeh Behrooj  1 , Nima Rahimi Petrudi  1 , Bahareh Ramezani  2
Affiliations
Review

The value of neutrophil-to-lymphocyte ratio in predicting severity of coronary involvement and long-term outcome of percutaneous coronary intervention in patients with acute coronary syndrome: a systematic review and meta-analysis

Farzad Shahsanaei et al. Egypt Heart J. .

Abstract

Background: The value of counting inflammatory cells and especially their counting ratio in predicting adverse clinical outcomes in patients with acute coronary syndrome (ACS) undergoing revascularization has been shown, but the results of studies have been very diverse and paradoxical. The aim of the current study was to systematically review the studies that investigated the role of increased neutrophil-to-lymphocyte ratio (NLR) in predicting long-term clinical outcomes in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).

Methods: Data abstraction was independently performed by both un-blinded reviewers on deeply assessing Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane Central Register of Controlled Trials and using the relevant keywords. The risk of bias for each study was assessed using the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions and the QUADAS-2 tool. Statistical analysis was performed using the Stata software. Overall, 14 articles published between 2010 and 2021 were eligible for the final analysis.

Results: A total of 20,846 ACS patients undergoing PCI were included. Higher values of NLR were associated with higher numbers of involved coronaries (RR: 1.175, 95%CI 1.021-1.353, P = 0.024). Increasing the value of NLR was associated with a 3.4 times increase in long-term death (RR: 3.424, 95%CI 2.325-5.025, P = 0.001). Similarly, higher values of NLR were significantly associated with a higher likelihood of long-term MACE (RR: 2.604, 95%CI 1.736-3.906, P = 0.001).

Conclusions: NLR has a high value in predicting both the severity of coronary artery involvement and long-term adverse clinical outcomes following the PCI procedure.

Keywords: Acute coronary syndrome; Major adverse cardiac event; Neutrophil-to-lymphocyte ratio; Percutaneous coronary intervention; Prognosis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The flowchart of screening the eligible studies
Fig. 2
Fig. 2
Methodological quality of the included studies
Fig. 3
Fig. 3
Predicting role of NLR in predicting the severity of coronary artery involvement
Fig. 4
Fig. 4
Predicting role of NLR in predicting long-term death following PCI
Fig. 5
Fig. 5
Predicting role of NLR in predicting long-term MACE following PCI
Fig. 6
Fig. 6
The funnel plots for assessment of the publication bias in assessment of the association of NLR with Multi-vessel (A), Death (B), and MACE (C)
See this image and copyright information in PMC

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