Preoperative neutrophil-lymphocyte ratio and outcome from coronary artery bypass grafting.
Am Heart J
; 154(5): 995-1002, 2007 Nov.
Article
en En
| MEDLINE
| ID: mdl-17967611
ABSTRACT
BACKGROUND:
An elevated preoperative white blood cell count has been associated with a worse outcome after coronary artery bypass grafting (CABG). Leukocyte subtypes, and particularly the neutrophil-lymphocyte (N/L) ratio, may however, convey superior prognostic information. We hypothesized that the N/L ratio would predict the outcome of patients undergoing surgical revascularization.METHODS:
Baseline clinical details were obtained prospectively in 1938 patients undergoing CABG. The differential leukocyte was measured before surgery, and patients were followed-up 3.6 years later. The primary end point was all-cause mortality.RESULTS:
The preoperative N/L ratio was a powerful univariable predictor of mortality (hazard ratio [HR] 1.13 per unit, P < .001). In a backward conditional model, including all study variables, it remained a strong predictor (HR 1.09 per unit, P = .004). In a further model, including the European system for cardiac operative risk evaluation, the N/L ratio remained an independent predictor (HR 1.08 per unit, P = .008). Likewise, it was an independent predictor of cardiovascular mortality and predicted death in the subgroup of patients with a normal white blood cell count. This excess hazard was concentrated in patients with an N/L ratio in the upper quartile (>3.36).CONCLUSION:
An elevated N/L ratio is associated with a poorer survival after CABG. This prognostic utility is independent of other recognized risk factors.
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Base de datos:
MEDLINE
Asunto principal:
Linfocitos
/
Puente de Arteria Coronaria
/
Isquemia Miocárdica
/
Neutrófilos
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Am Heart J
Año:
2007
Tipo del documento:
Article
País de afiliación:
Reino Unido