J Clin Med. 2020;9(2):jcm9020557.

Neutrophil-Lymphocyte Ratio in Patients with Acute Heart Failure Predicts In-Hospital and Long-Term Mortality.

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제1저자 조준환 · 교신저자 조현재

PMID 32085596 PMC7073552 DOI 10.3390/jcm9020557 IF 3.3 순환기내과

소속 (13)

Heart Research Institute, Cardiovascular-Arrhythmia Center, College of Medicine, Chung-Ang University Hospital, Seoul 06973, Korea.
Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Korea.
Department of Internal Medicine, Sungkyunkwan University College of Medicine, Seoul 06351, Korea.
Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju 28644, Korea.
Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu 41944, Korea.
Department of Internal Medicine, The Catholic University of Korea, Seoul 06591, Korea.
Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea.
Heart Research Center of Chonnam National University, Gwangju 61469, Korea.
Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
Professor Emeritus, Seoul National University College of Medicine, Seoul 03080, Korea.
Department of Cardiology, Mediplex Sejong Hospital, Incheon 21080, Korea.

Abstract

The application of a simple blood test to predict prognosis in acute heart failure (AHF) patients is not well established. Neutrophil-lymphocyte ratio (NLR) is inexpensive and easy to obtain in hospitalized patients using a routine blood test. We evaluate the prognostic implications of NLR as an independent predictor of in-hospital and long-term mortality in AHF patients. Among 5625 patients enrolled in the Korean Acute Heart Failure registry, 5580 patients were classified into quartiles by their NLR level, and analyzed for in-hospital and post-discharge three-year mortality. Patients in the highest NLR quartile had the highest in-hospital and post-discharge three-year mortality. The same results were seen by dividing the aggravating factor into the infection or ischemia group and the non-infection or non-ischemia group. For patients aggravated from infection or ischemia, a cut-off NLR value was 7.0 that increase the risk of in-hospital and post-discharge three-year mortality. In subgroups of patients not aggravated from infection or ischemia, a cut-off NLR value was 5.0 that increase the risk of in-hospital and post discharge three-year mortality. Elevated NLR in AHF patients at the index hospitalization is an independent predictor for in-hospital and post-discharge three-year mortality. Taken together, NLR is a marker for risk assessment of AHF patients.

Keywords

acute heart failuremortalityneutrophil-lymphocyte ratiooutcomesurvival

Figures

**Figure 1** Overall in-hospital mortality and 3-year survival after discharge. Quartile 1 (0.2–2.0); Quartile 2 (2.1–3.2), Quartile 3 (3.3–5.8), Quartile 4 (5.9–192,4).

**Figure 2** Overall in-hosptial mortality and 3-year survival after discharge of HF patients subgroup analysis by aggravating factor. (A) Quartile 1 (0.2–1.9), Quartile 2 (2.0–2.9), Quartile 3 (3.0–4.9), Quartile 4 (5.0–95.0); (B) Quartile 1 (0.2–2.3), Quartile 2 (2.4–3.8), Quartile 3 (3.9–7.0), Quartile 4 (7.1–192.4).

**Figure 3** Overall in-hosptial mortality and 3-year survival after discharge of HF patients whose aggravating factor were not-infection or non-ischemia divided by NLR 5.0.

**Figure 4** Overall in-hosptial mortality and 3-year survival after discharge of HF patients whose aggravating factor were infection or ischemia divided by NLR 5.0.

그림 출처: PubMed Central 공개 논문 (PMC7073552)

Conflict of interest statement

The authors declare no conflict of interest.

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