The value of neutrophil-to-lymphocyte ratio in predicting severity of coronary involvement and long-term outcome of percutaneous coronary intervention in patients with acute coronary syndrome: a systematic review and meta-analysis

Farzad Shahsanaei, Shahin Abbaszadeh, Soudabeh Behrooj, Nima Rahimi Petrudi, Bahareh Ramezani
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Abstract

The value of counting inflammatory cells and especially their counting ratio in predicting adverse clinical outcomes in patients with acute coronary syndrome (ACS) undergoing revascularization has been shown, but the results of studies have been very diverse and paradoxical. The aim of the current study was to systematically review the studies that investigated the role of increased neutrophil-to-lymphocyte ratio (NLR) in predicting long-term clinical outcomes in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Data abstraction was independently performed by both un-blinded reviewers on deeply assessing Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane Central Register of Controlled Trials and using the relevant keywords. The risk of bias for each study was assessed using the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions and the QUADAS-2 tool. Statistical analysis was performed using the Stata software. Overall, 14 articles published between 2010 and 2021 were eligible for the final analysis. A total of 20,846 ACS patients undergoing PCI were included. Higher values of NLR were associated with higher numbers of involved coronaries (RR: 1.175, 95%CI 1.021–1.353, P = 0.024). Increasing the value of NLR was associated with a 3.4 times increase in long-term death (RR: 3.424, 95%CI 2.325–5.025, P = 0.001). Similarly, higher values of NLR were significantly associated with a higher likelihood of long-term MACE (RR: 2.604, 95%CI 1.736–3.906, P = 0.001). NLR has a high value in predicting both the severity of coronary artery involvement and long-term adverse clinical outcomes following the PCI procedure.
中性粒细胞与淋巴细胞比值在预测急性冠状动脉综合征患者冠状动脉受累严重程度和经皮冠状动脉介入治疗长期疗效方面的价值:系统综述与荟萃分析
炎症细胞计数,尤其是其计数比值在预测接受血管再通手术的急性冠状动脉综合征(ACS)患者的不良临床结局方面的价值已经得到证实,但研究结果却五花八门,自相矛盾。本研究旨在系统回顾有关中性粒细胞与淋巴细胞比值(NLR)升高在预测接受经皮冠状动脉介入治疗(PCI)的急性冠状动脉综合征(ACS)患者长期临床结局中的作用的研究。数据摘要由两位非盲审稿人独立完成,他们深入评估了 Medline、Web of Knowledge、Google Scholar、Scopus 和 Cochrane Central Register of Controlled Trials,并使用了相关关键词。每项研究的偏倚风险均按照《科克伦干预措施系统综述手册》中列出的标准和 QUADAS-2 工具进行评估。统计分析使用 Stata 软件进行。共有 14 篇发表于 2010 年至 2021 年的文章符合最终分析的条件。共纳入了20846名接受PCI治疗的ACS患者。NLR值越高,受累冠状动脉的数量越多(RR:1.175,95%CI 1.021-1.353,P = 0.024)。NLR 值的增加与长期死亡人数增加 3.4 倍有关(RR:3.424,95%CI 2.325-5.025,P = 0.001)。同样,NLR 值越高,发生长期 MACE 的可能性越大(RR:2.604,95%CI 1.736-3.906,P = 0.001)。NLR 在预测冠状动脉受累的严重程度和 PCI 术后的长期不良临床结果方面具有很高的价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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