Neutrophil-to-Lymphocyte Ratio Useful as Cost-Effective Preliminary Prognostic Marker in ST-Elevation Myocardial Infarction

Background: The neutrophil-to-lymphocyte ratio (NLR) serves as a key indicator of inflammation and plays a vital role in assessing cardiovascular risk. Objective: This study aimed to evaluate the utility of NLR in predicting both early and short-term outcomes in patients presenting with ST-segment elevation myocardial infarction (STEMI). Patients and Methods: One hundred patients with STEMI who were at least eighteen years of age participated in this prospective observational study. Based on their NLR, the patients were split into two groups: Group I consisted of 77 patients with high NLR (>3) and Group II included 23 patients with normal NLR (1-3). Results: NLR can significantly predict complication during hospital admission (arrythmia, pulmonary edema, heart failure (HF) and death) (P<0.001) at cut-off (>6.92, >6.93, >6.72 and >6.94 respectively) with (66.67% and 50% respectively) sensitivity, (88.66%, 90.72%, 72.16% and 91.84% respectively) specificity. NLR can significantly predict complication at follow up (arrythmia, pulmonary edema, HF and death) (P=0.033, 0.020 and<0.001 respectively at cut-off >6.62, >6.71, >6.73 and >6.84 respectively) with (71.43%, 60.00%, 83.33% and 80.00% respectively) sensitivity, (69.23%, 69.89%, 77.17% and 87.10% respectively) specificity. Conclusions: The NLR at a cut-off value of >6.6 was significant prognostic marker for immediate and short-term outcomes in STEMI patients. NLR exhibit a sensitivity of 71.43% and specificity of 69.23%.