Original Research Article
Year: 2023 | Month: April-June | Volume: 8 | Issue: 2 | Pages: 27-34
DOI: https://doi.org/10.52403/gijhsr.20230206
Association of Total Leucocyte Count and Neutrophil to Lymphocyte Ratio with Short Term Major Adverse Cardiac Events after Acute ST Elevation Myocardial Infarction in a Tertiary Care Centre in South India
Dr Amrita Kurian1, Dr Poornima H2, Dr Abdul Salam3
1Junior Resident, Department of Internal Medicine, Government T D Medical College, Kerala University of Health Sciences, Alappuzha, India
2Professor, Department of Internal Medicine, Government T D Medical College, Kerala University of Health Sciences, Alappuzha, India
3Assistant Professor, Department of Cardiology, Government T D Medical College, Kerala University of Health Sciences, Alappuzha, India
Corresponding Author: Dr Amrita Kurian
ABSTRACT
Ischemic Heart Disease is a global health issue with developing countries bearing the brunt of the burden. The development of adverse cardiac events after an acute coronary event further aggravates the morbidity and mortality. In a developing country like India, employing inexpensive markers such as Total Leucocyte Count (TLC) and Neutrophil to Lymphocyte Ratio (NLR) can greatly aid prognostication in acute myocardial infarction.
The study aimed at estimating the association of TLC and NLR with short term Major Adverse Cardiac Events (MACE) after acute STEMI. We also studied the association of Total Leucocyte Count and Neutrophil to Lymphocyte ratio with TIMI (Thrombolysis in Myocardial Infarction) score.
This hospital based descriptive study that spanned over a year enrolled 270 patients admitted under General Medicine and Cardiology with STEMI. TLC and NLR were measured within 24 hours of admission. The subjects were followed up for MACE (namely heart failure hospitalization, compensated systolic dysfunction, arrhythmias, non-fatal reinfarction/stroke, and cardiovascular death) at the end of 1 week and 1 month.
Among the 270 cases, 107 developed MACE after 1 week and 89 developed MACE after 1 month. The most common MACE was LV systolic dysfunction followed by arrhythmias. There was a significant association between NLR and MACE after 1 week (p value:0.04). Similarly, there was a positive association between NLR and TIMI score (p value:0.002).
The association between total leucocyte count and MACE was not statistically significant.
We concluded that NLR, a routine, easily available test was effective in predicting major adverse cardiac events after 1 week in acute STEMI.
Keywords: Acute Coronary Syndrome; ST elevation myocardial infarction; Total leucocyte count; Neutrophil to Lymphocyte Ratio; Major Adverse Cardiac Events; Thrombolysis in Myocardial Infarction Score (TIMI score); LV systolic dysfunction