Value of Neutrophil to Lymphocyte Ratio and Its Trajectory in Patients Hospitalized With Acute Heart Failure and Preserved Ejection Fraction

被引:45
作者
Boralkar, Kalyani Anil [1 ]
Kobayashi, Yukari [1 ,2 ]
Amsallem, Myriam [1 ,2 ,6 ]
Ataam, Jennifer Arthur [1 ,2 ,3 ,6 ]
Moneghetti, Kegan J. [1 ,2 ]
Cauwenberghs, Nicholas [4 ]
Horne, Benjamin D. [1 ,5 ]
Knowlton, Kirk U. [5 ]
Maecker, Holden [3 ]
Kuznetsova, Tatiana [4 ]
Heidenreich, Paul A. [1 ]
Haddad, Francois [1 ,2 ]
机构
[1] Stanford Univ, Sch Med, Stanford, CA 94305 USA
[2] Stanford Cardiovasc Inst, Stanford, CA 94305 USA
[3] Inst Immun Transplantat & Infect, Stanford, CA USA
[4] Univ Leuven, KU Leuven, Res Unit Hypertens & Cardiovasc Epidemiol, Dept Cardiovasc Sci, Leuven, Belgium
[5] Intermt Heart Inst, Salt Lake City, UT USA
[6] Paris Sud Univ, Marie Lannelongue Hosp, DHU TORINO, Res & Innovat Unit,INSERM U999, Le Plessis Robinson, France
关键词
CELL DISTRIBUTION WIDTH; PROGNOSTIC VALUE; RISK SCORE; MORTALITY; INFLAMMATION; ASSOCIATION; PROGRAM; UTILITY; HEALTH; COUNT;
D O I
10.1016/j.amjcard.2019.10.020
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The neutrophil to lymphocyte ratio (NLR) has been proposed as a simple and routinely obtained marker of inflammation. This study sought to determine whether the NLR on admission as well as NLR trajectory would be complementary to the Get with the Guidelines Heart Failure (GWTG-HF) risk score in patients hospitalized with acute heart failure with preserved ejection fraction (HFpEF).Using the Stanford Translational Research Database, we identified 443 patients between January 2002 and December 2013 hospitalized with acute HFpEF and with complete data of NLR both on admission and at discharge. The primary endpoint was all-cause mortality. Mean age was 77 +/- 16 years, 58% were female, with a high prevalence of diabetes mellitus (35.4%), coronary artery disease (58.2%), systemic hypertension (96.6%) and history of atrial fibrillation (57.5%). Over a median follow-up of 2.2 years, 121 (27.3%) patients died. The median NLR on admission was 6.5 (IQR 3.6 - 11.1); a majority of patients decreased their NLR during the course of hospitalization. On multivariable Cox modeling, both NLR on admission (HR 1.18 95% CI (1.00-.38), p = 0.04) and absolute NLR trajectory (HR 1.26 95% CI (1.10 - 1.45), p = 0.001) were shown to be incremental to GWTG-HF risk score (p < 0.05) for outcome prediction. Adding the NLR or absolute NLR trajectory to the GWTG-HF risk score significantly improved the area under the operator-receiver curve and the reclassification up to 3 years after admission.This simple, readily available marker of inflammation may be useful when stratifying the risk of patients hospitalized with HFpEF. (C) 2019 Elsevier Inc. All rights reserved.
引用
收藏
页码:229 / 235
页数:7
相关论文
共 28 条
  • [11] Complete blood count risk score and its components, including RDW, are associated with mortality in the JUPITER trial
    Horne, Benjamin D.
    Anderson, Jeffrey L.
    Muhlestein, Joseph B.
    Ridker, Paul M.
    Paynter, Nina P.
    [J]. EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, 2015, 22 (04) : 519 - 526
  • [12] Hemographic indices are associated with mortality in acute heart failure
    Huang, Wei-Ming
    Cheng, Hao-Min
    Huang, Chi-Jung
    Guo, Chao-Yu
    Lu, Dai-Yin
    Lee, Ching-Wei
    Hsu, Pai-Feng
    Yu, Wen-Chung
    Chen, Chen-Huan
    Sung, Shih-Hsien
    [J]. SCIENTIFIC REPORTS, 2017, 7
  • [13] Association of Neutrophil-to-Lymphocyte Ratio With Mortality and Cardiovascular Disease in the Jackson Heart Study and Modification by the Duffy Antigen Variant
    Kim, Stephanie
    Eliot, Melissa
    Koestler, Devin C.
    Wu, Wen-Chih
    Kelsey, Karl T.
    [J]. JAMA CARDIOLOGY, 2018, 3 (06) : 455 - 462
  • [14] Relative hypochromia and mortality in acute heart failure
    Kleber, Martina
    Kozhuharov, Nikola
    Sabti, Zaid
    Glatz, Bettina
    Isenreich, Rahel
    Wussler, Desiree
    Nowak, Albina
    Twerenbold, Raphael
    Badertscher, Patrick
    Puelacher, Christian
    de lavallaz, Jeanne du Fay
    Nestelberger, Thomas
    Boeddinghaus, Jasper
    Wildi, Karin
    Flores, Dayana
    Walter, Joan
    Rentsch, Katharina
    von Eckardstein, Arnold
    Goudev, Assen
    Breidthardt, Tobias
    Mueller, Christian
    [J]. INTERNATIONAL JOURNAL OF CARDIOLOGY, 2019, 286 : 104 - 110
  • [15] Lowe Henry J, 2009, AMIA Annu Symp Proc, V2009, P391
  • [16] Markers of inflammation and cardiovascular disease application to clinical and public health practice - A statement for healthcare professionals from the centers for disease control and prevention and the American Heart Association
    Pearson, TA
    Mensah, GA
    Alexander, RW
    Anderson, JL
    Cannon, RO
    Criqui, M
    Fadl, YY
    Fortmann, SP
    Hong, Y
    Myers, GL
    Rifai, N
    Smith, SC
    Taubert, K
    Tracy, RP
    Vinicor, F
    [J]. CIRCULATION, 2003, 107 (03) : 499 - 511
  • [17] A Validated Risk Score for In-Hospital Mortality in Patients With Heart Failure From the American Heart Association Get With the Guidelines Program
    Peterson, Pamela N.
    Rumsfeld, John S.
    Liang, Li
    Albert, Nancy M.
    Hernandez, Adrian F.
    Peterson, Eric D.
    Fonarow, Gregg C.
    Masoudi, Frederick A.
    [J]. CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES, 2010, 3 (01): : 25 - 32
  • [18] Neutrophil-Lymphocyte Ratio: Prognostic Impact in Heart Surgery. Early Outcomes and Late Survival
    Silberman, Shuli
    Abu-Yunis, Ulfat
    Tauber, Rachel
    Shavit, Linda
    Grenader, Tal
    Fink, Daniel
    Bitran, Daniel
    Merin, Ofer
    [J]. ANNALS OF THORACIC SURGERY, 2018, 105 (02) : 581 - 586
  • [19] The American Heart Association Get With The Guidelines program
    Smaha, LA
    [J]. AMERICAN HEART JOURNAL, 2004, 148 (05) : S46 - S48
  • [20] Red cell distribution width and mortality in acute heart failure patients with preserved and reduced ejection fraction
    Sotiropoulos, Konstantinos
    Yerly, Patrick
    Monney, Pierre
    Garnier, Antoine
    Regamey, Julien
    Hugli, Olivier
    Martin, David
    Metrich, Melanie
    Antonietti, Jean-Philippe
    Hullin, Roger
    [J]. ESC HEART FAILURE, 2016, 3 (03): : 198 - 204