Neutrophil-to-lymphocyte ratio predicts myocardial injury after noncardiac surgery
The neutrophil-to-lymphocyte ratio (NLR) appears to be a simple and easy method for predicting the development of myocardial injury after noncardiac surgery (MINS), a recent study has shown.
Peak high-sensitivity cardiac troponin T (hs-cTnT; 126.6 vs 7.5; p<0.000), mean neutrophil count (6,498±819 vs 5,978±998 mm-3; p=0.007) and median C-reactive protein (CRP) levels (3.0 vs 2.5; p=0.02) were significantly higher in those with vs without MINS, as was mean NLR (3.79±0.7 vs 2.69±0.6; p<0.0001).
In contrast, lymphocyte count was significantly lower in patients with MINS (1,857±331 vs 2,038±391 mm-3; p=0.016).
Moreover, multivariate logistic regression analysis showed that the variables independently and significantly associated with MINS were age (odds ratio [OR], 1.081; 95 percent CI, 1.004–1.165; p=0.039), CRP concentration (OR, 1.552; 1.009–2.386; p=0.045), lymphocyte count (OR, 1.002; 1.001–1.004; p=0.040) and NLR (OR, 11.690; 4.619–29.585; p<0.000).
At a cutoff value of 3.3, receiver operating characteristic analysis showed that NLR could predict MINS with an 80-percent sensitivity and 84-percent specificity (area under the curve, 0.85; 0.78–0.93).
The findings of the present study support the use of preoperative NLR as an easy, inexpensive and noninvasive marker for the detection of patients at high risk of cardiac complications after noncardiac surgery.
Using blood samples collected from 255 patients who underwent noncardiac surgery after a 12-hour fast, researchers measured CRP, glucose and triglyceride levels, along with blood cell counts. Electrocardiography and hs-cTnT measurements were performed immediately after surgery and at 1 and 3 days after surgery.