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( Kristian Anteolin Punzalan ),( Regidor Encabo ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1
Background: Infl ammation plays a key role in the development of coronary atherosclerosis and acute coronary syndrome (ACS). Recent studies suggested that specifi c subtypes of leukocytes can be used as predictor in assessing cardiovascular risk in which the value is higher when neutrophil to lymphocyte ratio (NLR) is used. Objective: To evaluate NLR on admission as an independent predictor of in-hospital mortality among ACS patients. Methods: This study retrospectively evaluated patients admitted and diagnosed with ACS at Cardinal Santos Medical Center. Chart records of 280 ACS patients were screened and evaluated. Patients who have history of percutaneous coronary intervention, malignancy, concurrent infection, recent surgery, current use of immunosuppressors and anti-infl ammatory drugs were excluded from the study. Patients were stratifi ed into 2 groups based on a cut-off of 3.5 NLR done from previous studies. NLR was labeled as Low if <3.5 and High if >3.5. The major outcome of this study was in-hospital mortality. Results: Correlation analysis showed a signifi cant positive correlation between demographic profi les, NLR and mortality among STEMI (P-value 0.038) and NSTEMI (P-value 0.041). In the univariate logistic analysis, signifi cant predictors of in-hospital mortality were sex (OR 12.091, P-value 0.002) and NLR (OR 10.909, P-value 0.050) among STEMI while dyslipidemia (OR 2.316, P-value 0.046) and NLR (OR 5.741, P-value 0.019) among NSTEMI. On multivariate analysis, NLR was found to be an independent predictor of in-hospital mortality for both STEMI (OR 10.234, P-value 0.048) and NSTEMI (OR 5.354, P-value 0.021). Conclusions: NLR on admission, is an independent predictor of in-hospital mortality among patients diagnosed with STEMI and NSTEMI but not UA.