Neutrophil to Lymphocyte Ratio is Associated with Adverse Long Term Outcomes in Heart Failure Patients

Abstract

Introduction: Neutrophil-to-lymphocyte (N/L) ratio has been associated with adverse outcomes in patients with acute coronary syndromes, increased arterial stiffness and increased risk short-term mortality in patients with acute heart failure. We aimed to investigate the prognostic value of neutrophil-to-lymphocyte ratio on long term outcomes in patients with chronic heart failure.Methods: 1579 heart failure undergoing coronary angiogram were enrolled. Absolute neutrophil and lymphocyte count was assessed on enrolment and (N/L) ratio was calculated. Patient were grouped quintiles based on levels of (N/L) ratio. Kaplan Meir analysis was used to assess 5 year mortality. Results: In our population (age 66 611, Male 65%, DM 38%, HTN 79%, MI 55%), mean absolute neutrophil and lymphocyte counts were 4.7 6 2.2 x10cells/micro Liter and 1.5 6 0.7 x10cells/micro Liter respectively. Median (IQR) (N/L) ratio was 3.1 (2.2-4.7)%. Positive correlation was found between (N/ L) ratio and high-sensitivity C-reactive protein (R50.25, p!0.001). Patients with increased (N/L) ratio had significantly increased 5 year mortality (log rank !0.001, Figure). Conclusion: Neutrophil to lymphocyte ratio is associated with increased 5 year mortality in heart failure patients.