Wada H, et al. – This study tested neutrophil–to–lymphocyte ratio (NLR) as an independent predictor of long–term cardiac outcomes following percutaneous coronary intervention (PCI). Elevated NLR independently predicted long–term cardiovascular outcomes after elective PCI. For risk stratification of stable coronary artery disease (CAD), evaluation of pre–PCI NLR may be beneficial.

Methods

• This study included a total of 2070 patients with CAD who underwent elective PCI.
• Researchers categorized patients into 3 groups by NLR tertile (<1.7, 1.7–2.5, and 2.5<).
• They assessed incidences of all-cause death and cardiac death.

Results

• During follow-up (median, 7.4 years), 300 patients (14.5%) died.
• Ongoing divergence in rates of all-cause death and cardiac death among tertiles (both log-rank p < 0.01) was shown in Kaplan-Meier curves.
• Researchers observed that, in multivariate analysis, using the lowest tertile as reference, the highest tertile remained significantly associated with greater incidences of all-cause death (hazard ratio (HR), 1.73; 95% confidence interval (CI), 1.29–2.34; p = 0.0002).
• Findings demonstrated that continuous NLR values were also an independent predictor of all-cause death (HR, 1.87 per log NLR 1 increase; 95% CI, 1.50–2.32; p < 0.0001) and cardiac death (HR, 2.11; 95% CI, 1.46–3.05; p < 0.0001).
• In addition, data revealed that adding NLR values to a baseline model with established risk factors improved the C-index (p = 0.002), net reclassification improvement (p = 0.008) and integrated discrimination improvement (p = 0.0001) for all-cause death.