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Published online: 2021-01-11
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Incremental predictive value of the combined use of the neutrophil-to-lymphocyte ratio and systolic blood pressure difference after successful drug-eluting stent implantation

Yong Hoon Kim, Ae-Young Her, Scot Garg, Eun-Seok Shin
DOI: 10.5603/CJ.a2021.0004
·
Pubmed: 33438177

open access

Ahead of print
Original articles
Published online: 2021-01-11

Abstract

Background: Previous work has highlighted the importance of the neutrophil-to-lymphocyte ratio (NLR) and the difference in the ward-to-catheterization laboratory systolic blood pressure (ΔSBP) in prognostic stratification after acute coronary syndrome. However, there is paucity of data regarding the added value of combining these two variables to predict 5-year major clinical outcomes after percutaneous coronary intervention. Methods: A total of 1188 patients were classified into four groups according to the NLR and ΔSBP (high vs. low) using cutoffs derived from an analysis of receiver operating characteristic curves. A NLR > 3.0 and a ΔSBP > 25 mmHg were considered high values. The primary endpoint was the composite of all-cause death, cardiac death, and non-fatal myocardial infarction. The secondary endpoint was the composite of target lesion revascularization, target vessel revascularization, and incidence of cerebrovascular accidents. Results: The incidence of the primary endpoint was significantly higher in the high NLR and ΔSBP group than in the other three groups (2.2% vs. 4.7% vs. 4.3% vs. 13.2%, p < 0.001). The incidence of the secondary endpoint was similar among the four groups. Incorporation of high NLR and high ΔSBP into a model with conventional and meaningful clinical and procedural risk factors increased the C-statistics in predicting the primary endpoint (0.575 to 0.635, p = 0.002). Conclusions: The power to predict the primary endpoint after drug-eluting stent implantation at the 5-year follow-up was improved by combining NLR and ΔSBP.

Abstract

Background: Previous work has highlighted the importance of the neutrophil-to-lymphocyte ratio (NLR) and the difference in the ward-to-catheterization laboratory systolic blood pressure (ΔSBP) in prognostic stratification after acute coronary syndrome. However, there is paucity of data regarding the added value of combining these two variables to predict 5-year major clinical outcomes after percutaneous coronary intervention. Methods: A total of 1188 patients were classified into four groups according to the NLR and ΔSBP (high vs. low) using cutoffs derived from an analysis of receiver operating characteristic curves. A NLR > 3.0 and a ΔSBP > 25 mmHg were considered high values. The primary endpoint was the composite of all-cause death, cardiac death, and non-fatal myocardial infarction. The secondary endpoint was the composite of target lesion revascularization, target vessel revascularization, and incidence of cerebrovascular accidents. Results: The incidence of the primary endpoint was significantly higher in the high NLR and ΔSBP group than in the other three groups (2.2% vs. 4.7% vs. 4.3% vs. 13.2%, p < 0.001). The incidence of the secondary endpoint was similar among the four groups. Incorporation of high NLR and high ΔSBP into a model with conventional and meaningful clinical and procedural risk factors increased the C-statistics in predicting the primary endpoint (0.575 to 0.635, p = 0.002). Conclusions: The power to predict the primary endpoint after drug-eluting stent implantation at the 5-year follow-up was improved by combining NLR and ΔSBP.

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Keywords

blood pressure difference, drug-eluting stent, neutrophil-to-lymphocyte ratio, outcomes, percutaneous coronary intervention

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Title

Incremental predictive value of the combined use of the neutrophil-to-lymphocyte ratio and systolic blood pressure difference after successful drug-eluting stent implantation

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2021-01-11

DOI

10.5603/CJ.a2021.0004

Pubmed

33438177

Keywords

blood pressure difference
drug-eluting stent
neutrophil-to-lymphocyte ratio
outcomes
percutaneous coronary intervention

Authors

Yong Hoon Kim
Ae-Young Her
Scot Garg
Eun-Seok Shin

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