Tolga Sinan Guvenc1, Ahmet Ekmekci1,5, Mahmut Uluganyan2, Gokhan Ertas1, Hatice Betul Erer1, Fatma Ozpamuk Karadeniz1, Ozan Tanik1, Ahmet Oz1, Cevdet Kocogullari3, Yalcin Velibey1, Gurkan Karaca4, Mehmet Eren11Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey
2Clinic of Cardiology, Yedikule Thoracic Disease and Surgery Center Training and Research Hospital, Istanbul, Turkey
3Clinic of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey
4Clinic of Cardiology, Osmancik Government Hospital, Corum, Turkey
5Electronic correspondence: firstname.lastname@example.org
Background and aim of the study: 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.
Methods: 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).
Results: 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).
Conclusion: The NLR is a useful parameter to assess postoperative in-hospital mortality risk after valvular surgery.
The Journal of Heart Valve Disease 2016;25:389-396
|Prognostic Value of Neutrophil-to-Lymphocyte Ratio for Patients Undergoing Heart Valve Replacement|
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