Heart FailureUsefulness of Neutrophil-to-Lymphocyte Ratio in Risk Stratification of Patients With Advanced Heart Failure
Section snippets
Methods
We analyzed 549 consecutive patients presented to the Cleveland Clinic (Cleveland, Ohio) from 2007 to 2010 for evaluation of advanced HF therapies and consideration for heart transplantation or mechanical circulatory assist devices. Electronic medical records were used to obtain demographic variables (age, gender, and race), clinical variables, laboratory values, and medications. Among this cohort, 527 patients had documented values of NLR within the time frame and clinical stability to
Results
Of the 527 patients, 176, 177, and 174 patients were in the lowest, intermediate, and higher NLR tertile, respectively. Baseline characteristics of the patients across NLR tertiles are listed in Table 1. Overall, NLR correlated directly with B-type natriuretic peptide (r = 0.14, p <0.01). There was no correlation between NLR and left ventricular ejection fraction, peak oxygen consumption, and hemodynamic variables. The distribution of the logarithm of NLR is presented in Figure 1, stratified
Discussion
The key finding of this analysis is that patients with advanced HF and higher levels of NLR portend higher mortality or heart transplantation risk. This association was mainly driven by higher all-cause mortality risk, as we did not find association between NLR and heart transplantation after multivariate adjustments. Although NLR may link to mortality like several other conditions, the potential contributory role of NLR in disease progression is not supported by our analysis. Thus, it appears
Disclosures
The authors have no conflicts of interest to disclose.
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This research was supported by National Institutes of Health grant RO1 HL103931.
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