Relation of admission neutrophil/lymphocyte ratio to angiographic no-reflow phenomenon in patients with ST-elevated myocardial infarction undergoing primary coronary intervention

Abstract

To investigate the relationship of the neutrophil/lymphocyte ratio (NLR) on admission and angiographic no-reflow phenomenon in patients with ST-segment elevation myocardial infarction (STEMI) who had undergone primary percutaneous coronary intervention (PCI). 232 patients who had undergone PCI between 2010 and 2013, were included and divided into two groups based upon the thrombolysis in myocardial infarction (TIMI) flow gradings. No-reflow was defined as post-PCI TIMI Grade 0, 1 and 2 flows (group I). Normal-flow was defined as TIMI 3 flow (group II). Receiver operating characteristic curve (ROC) analysis was used to identify the predictive effect of NLR on no-reflow phenomenon. Relationship of NLR and no-reflow was assessed by multivariate logistic regression. All statistical calculations and analyses were performed using SPSS 11.0. NLR was significantly higher in group I (n = 45) compared with group II (n = 187) [4.1(2.4-6.5) vs. 2.4 (1.7-3.8), P = 0.001]. In ROC analysis, NLR>3.2 predicted no reflow with 80% sensitivity and 73% specificity. Patients with elevated NLR had a higher incidence of no-reflow phenomenon than those with non-elevated NLR (34.8% vs. 9.3%, P < 0.001). Also, NLR (>3.2) was an independent predictor of no-reflow development [odds ratio 3.70, 95% confidence interval(1.39-9.80), P = 0.009]. NLR was an independent predicator for no-reflow development in STEMI patients who had undergone PCI. This simple and low-cost parameter could provide useful information for the early risk evaluation on these patients.