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Neutrophil to lymphocyte ratio might help prediction of acute myocardial infarction in patients with elevated serum creatinine
BACKGROUND AND OBJECTIVE: Diagnostic performance of troponin assays is affected by renal insufficiency. Neutrophil to lymphocyte ratio(NLR) is an independent predictor of acute coronary syndrome. Our objective was to evaluate performance of NLR in diagnosing acute myocardial infarction (AMI) among p...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Professional Medical Publications
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795847/ https://www.ncbi.nlm.nih.gov/pubmed/27022355 http://dx.doi.org/10.12669/pjms.321.8712 |
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author | Nalbant, Ahmet Cinemre, Hakan Kaya, Tezcan Varim, Ceyhun Varim, Perihan Tamer, Ali |
author_facet | Nalbant, Ahmet Cinemre, Hakan Kaya, Tezcan Varim, Ceyhun Varim, Perihan Tamer, Ali |
author_sort | Nalbant, Ahmet |
collection | PubMed |
description | BACKGROUND AND OBJECTIVE: Diagnostic performance of troponin assays is affected by renal insufficiency. Neutrophil to lymphocyte ratio(NLR) is an independent predictor of acute coronary syndrome. Our objective was to evaluate performance of NLR in diagnosing acute myocardial infarction (AMI) among patients with elevated serum creatinine. METHODS: Patients with elevated creatinine levels evaluated for coronary artery disease were included (n=284). Patients were divided into two groups according to having AMI or non-specific chest pain. AMI diagnosis was made based on clinical and laboratory data, including serial EKG and cardiac enzymes, ECHO and coronary angiography. RESULTS: Troponin, neutrophil, and NLR were found to be higher in patients with AMI, compared to patients without AMI (P= 0.001, P= 0.001 and P=0.028, respectively). ROC curve analysis for NLR in diagnosing AMI was significant (AUC: 0.607; P=0.003). Sensitivity, specificity, LR +, LR-, PPV and NPV for NLR>7.4 were found as 42.3%, 74.7%, 1.68%, 0.77%, 77% and 40%, respectively. Logistic regression analysis revealed that patients whose NLR>7.4 were 2.18 times as likely to have AMI. CONCLUSIONS: NLR can be used as an independent predictor of AMI in patients with renal insufficiency. This seems to get more important in the era of high sensitivity troponin assays. Our results might also help in early diagnosis of AMI in this high risk population while serial cardiac enzyme results are pending. |
format | Online Article Text |
id | pubmed-4795847 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Professional Medical Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-47958472016-03-28 Neutrophil to lymphocyte ratio might help prediction of acute myocardial infarction in patients with elevated serum creatinine Nalbant, Ahmet Cinemre, Hakan Kaya, Tezcan Varim, Ceyhun Varim, Perihan Tamer, Ali Pak J Med Sci Original Article BACKGROUND AND OBJECTIVE: Diagnostic performance of troponin assays is affected by renal insufficiency. Neutrophil to lymphocyte ratio(NLR) is an independent predictor of acute coronary syndrome. Our objective was to evaluate performance of NLR in diagnosing acute myocardial infarction (AMI) among patients with elevated serum creatinine. METHODS: Patients with elevated creatinine levels evaluated for coronary artery disease were included (n=284). Patients were divided into two groups according to having AMI or non-specific chest pain. AMI diagnosis was made based on clinical and laboratory data, including serial EKG and cardiac enzymes, ECHO and coronary angiography. RESULTS: Troponin, neutrophil, and NLR were found to be higher in patients with AMI, compared to patients without AMI (P= 0.001, P= 0.001 and P=0.028, respectively). ROC curve analysis for NLR in diagnosing AMI was significant (AUC: 0.607; P=0.003). Sensitivity, specificity, LR +, LR-, PPV and NPV for NLR>7.4 were found as 42.3%, 74.7%, 1.68%, 0.77%, 77% and 40%, respectively. Logistic regression analysis revealed that patients whose NLR>7.4 were 2.18 times as likely to have AMI. CONCLUSIONS: NLR can be used as an independent predictor of AMI in patients with renal insufficiency. This seems to get more important in the era of high sensitivity troponin assays. Our results might also help in early diagnosis of AMI in this high risk population while serial cardiac enzyme results are pending. Professional Medical Publications 2016 /pmc/articles/PMC4795847/ /pubmed/27022355 http://dx.doi.org/10.12669/pjms.321.8712 Text en Copyright: © Pakistan Journal of Medical Sciences http://creativecommons.org/licenses/by/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Nalbant, Ahmet Cinemre, Hakan Kaya, Tezcan Varim, Ceyhun Varim, Perihan Tamer, Ali Neutrophil to lymphocyte ratio might help prediction of acute myocardial infarction in patients with elevated serum creatinine |
title | Neutrophil to lymphocyte ratio might help prediction of acute myocardial infarction in patients with elevated serum creatinine |
title_full | Neutrophil to lymphocyte ratio might help prediction of acute myocardial infarction in patients with elevated serum creatinine |
title_fullStr | Neutrophil to lymphocyte ratio might help prediction of acute myocardial infarction in patients with elevated serum creatinine |
title_full_unstemmed | Neutrophil to lymphocyte ratio might help prediction of acute myocardial infarction in patients with elevated serum creatinine |
title_short | Neutrophil to lymphocyte ratio might help prediction of acute myocardial infarction in patients with elevated serum creatinine |
title_sort | neutrophil to lymphocyte ratio might help prediction of acute myocardial infarction in patients with elevated serum creatinine |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795847/ https://www.ncbi.nlm.nih.gov/pubmed/27022355 http://dx.doi.org/10.12669/pjms.321.8712 |
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