Prognostic Value of Neutrophil-to-Lymphocyte Ratio for Patients Undergoing Heart Valve Replacement
Sinan Guvenc, T.; Ekmekci, A.; Uluganyan, M.; Ertas, G.; Betul Erer, H.; Ozpamuk Karadeniz, F.; Tanik, O.; Oz, A.; Kocogullari, C.; Velibey, Y.; Karaca, G.; Eren, M.
Journal of Heart Valve Disease 25(3): 389-396
2016
ISSN/ISBN: 0966-8519 PMID: 27989052 Document Number: 690171
The neutrophil-tolymphocyte ratio (NLR) was found to be a predictor of adverse outcome in patients with coronary artery disease (CAD). The ratio may also be a useful marker to predict mortality following valve replacement surgery. A total of 932 patients was enrolled retrospectively. Patients were allocated to three tertiles based on their NLR (group 1, NLR ≤1.90; group 2, 1.90 < NLR ≤2.93; group 3, NLR >2.93). Patients in the highest tertile were older (p = 0.049, 95% CI 0.09-5.98), tended to have chronic renal failure (p = 0.028, OR: 2.6, 95% CI 1.08-6.35), and had more frequent critical CAD on preoperative angiography (p <0.001, OR 2.1, 95% CI 1.38-3.21). Postoperatively, patients in the highest NLR tertile had a higher in-hospital mortality rate than those in the first tertile (p <0.001, OR 4.67, 95% CI 2.37-9.20) and second tertile (p = 0.002, OR 2.26, 95% CI 1.32-3.86). Patients in the third tertile had the highest mortality at day 300 (log-rank p <0.001). The hazard ratio (HR) for the second tertile was 1.8 (p = 0.11, 95% CI 0.88-3.79), and for the third tertile was 2.8 (p = 0.003, 95% CI 1.40-5.59). The NLR is a useful parameter to assess postoperative in-hospital mortality risk after valvular surgery.