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Article Type

Original Study

Abstract

Background Inflammatory processes have a role in the pathogenesis of acute myocardial infarction (AMI), left ventricular remodeling, and repair. Infarct size (IS) is a strong predictor of prognosis following AMI. Several tools are used to predict IS, but most of them are expensive and inaccessible all the time. So, neutrophil-to-lymphocyte ratio (NLR) as a marker of inflammation is an easy and cheap tool to predict IS. Aim To assess if post-percutaneous coronary intervention (PCI) NLR can predict IS in patients with AMI. Patients and methods The study included 11 125 patients with AMI treated with primary PCI. We used cardiovascular magnetic resonance imaging following PCI to measure IS. We performed a full blood cell count within 1 day before PCI and after it. Patients were classified into two groups regarding NLR by using a cutoff value of 3.88. Patients were divided into high-NLR group (n = 48) or low-NLR group (n = 77). IS was our primary outcome. Results The high-NLR group had significantly higher IS than the low-NLR group (24.82 ± 11.33 vs. 17.20 ± 9.37, P < 0.001). We found that post-PCI NLR more than or equal to 3.88 was associated with large-sized infarction (odds ratio 2.997, 95% confidence interval 1.782–5.026, P < 0.001). The high-NLR group had significantly higher major adverse cardiac events risk than the low-NLR group (P = 0.015, 16.7 vs. 7.8%, hazard ratio 2.678, 95% confidence interval 1.246–5.768). Conclusions Post-PCI NLR may be used to predict IS and prognosis of patients with AMI revascularized by PCI.

Keywords

Acute myocardial infarction, infarct size, post-PCI NLR

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