The neutrophil to lymphocyte ratio is associated with severity of rheumatic mitral valve stenosis
Authors Baysal E, Burak C, Cay S, Aksu T, AltÄ±ntaĹź B, Yaylak B, SevĂĽk U, Bilge
Received 8 February 2015
Accepted for publication 11 March 2015
Published 13 May 2015 Volume 2015:6 Pages 151—156
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Martin H. Bluth
Erkan Baysal,1 Cengiz Burak,2 Serkan Cay,2 Tolga Aksu,3 Bernas AltintaĹź,1 BariĹź Yaylak,1 Utkan Sevük,4 Önder Bilge1
1Department of Cardiology, Diyarbakir Gazi YaĹźargil Education and Research Hospital, Diyarbakir, Turkey; 2Department of Cardiology, Ankara Yüksek Ihtisas Education and Research Hospital, Ankara, Turkey; 3Department of Cardiology, Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey; 4Department of Cardiovascular Surgery, Diyarbakir Gazi YaĹźargil Education and Research Hospital, Diyarbakir, Turkey
Background: Rheumatic heart disease (RHD) is a serious health concern in developing countries. Rheumatic mitral stenosis (RMS) is the most long-term sequel in RHD. The neutrophil to lymphocyte ratio (NLR) is a novel marker, and a higher NLR has been associated with poor clinical outcomes in various cardiovascular disorders. We evaluated the availability of NLR to predict severity of mitral stenosis (MS) in patients with RHD.
Methods: We analyzed 300 consecutive patients with RMS. The patients were divided into tertiles according to NLR: 0.85< NLR ≤1.85 (n=100, tertile 1), 1.86≤ NLR ≤2.46 (n=100, tertile 2), and 2.47≤ NLR ≤7.08 (n=100, tertile 3). Patients with RMS were divided into three groups based on the degree of MS as mild, moderate, and severe MS. After the initial evaluation, 187 patients with moderate-to-severe RMS (Group 1) and 113 patients with mild RMS (Group 2) were reassessed.
Results: The patients with severe RMS had significantly elevated NLR, mean platelet volume, and pulmonary artery systolic pressure values compared to patients with moderate and mild MS (P<0.001, P<0.001, P<0.001 respectively). Multivariate binary logistic regression analysis revealed that high levels of NLR was an independent predictor of severe RMS (odds ratio =0.68, P=0.008). Moderate-to-severe RMS incidence was significantly higher among patients in the tertile 3 (odds ratio =2.8, P=0.001).
Conclusion: NLR is a new inflammatory marker and a simple, rapid, and easily accessible prognostic parameter that can be associated with severity of RMS in patients with RHD.
Keywords: rheumatic heart disease, rheumatic mitral stenosis, neutrophil to lymphocyte ratio
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