Objective
Atherosclerosis is a multifactorial disease and is the major cause of cardiovascular disease that still accounts for most of the mortality worldwide. The role of inflammation in the development and progression of atherosclerosis has been clarified and several biological markers of inflammation predict cardiovascular risk. Red cell distribution width (RDW) and neutrophil-to-lymphocyte ratio (NLR) are the two markers of inflammation that are used to determine risk of mortality and adverse cardiovascular outcomes in patients with acute myocardial infarction. Left ventricular ejection fraction (LVEF) has been shown to be an efficacious predictor of prognosis after AMI. The relationship between RDW, NLR and left ventricular systolic functions is unknown. The goal of this study was to evaluate the relationship between RDW, NLR levels on admission and left ventricular systolic functions in first anterior STEMI patients who underwent primary percutaneous coronary intervention (PCI).
Methods
248 patients enrolled with first anterior STEMI, 142 patients were excluded due to exclusion criteria (Figure 1). RDW and NLR were measured on admission in 106 STEMI patients treated with primary PCI. Patients were divided into two groups according to LVEF, as group I (systolic dysfunction, LVEF<50%) and group II (preserved global left ventricle systolic function, LVEF≥50%). The first group consisted of 47 patients, the second group consisted of 59 patients, respectively.
Methods
248 patients enrolled with first anterior STEMI, 142 patients were excluded due to exclusion criteria (Figure 1). RDW and NLR were measured on admission in 106 STEMI patients treated with primary PCI. Patients were divided into two groups according to LVEF, as group I (systolic dysfunction, LVEF<50%) and group II (preserved global left ventricle systolic function, LVEF≥50%). The first group consisted of 47 patients, the second group consisted of 59 patients, respectively.
Results
On comparision of two groups, there were no differences in age, gender, body mass index, hypertension, DM, smoking status, TIMI flow, localization of the culprit lesion, use of glycoprotein IIb/IIIa inhibitors, blood glucose levels, creatinine, Troponin, hemoglobin, hematocrit, leukocyte, MCV, platelet and LDL levels. There was a significant differences in neutrophil and lymhocyte counts, RDW (13.7±0.9% vs 13.4±0.7%, p=0.03) and NLR (5.86 (0.66-40.50) vs 2.75 (0.51-39.39), p=0.013) levels (Table 1). For LV systolic dysfunction; age, NLR, RDW and fasting glucose level at admission were analyzed using a multivariate logistic regression model. The RDW was the only independent predictor of LV systolic dysfunction (odds ratio 1.797, confidence interval 95%: 1.062-3.041, p = 0.029).
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