Total Neutrophil Count and Neutrophil/Lymphocyte Ratio in Predicting In-Hospital Mortality and Complications after St Segment Elevation Myocardial Infarction

Naseem  Akhter; Ahmed Raza  Khan; Hussain  Farooq; Shazia  Maqbool; Namra  Mahmood; Afra  Samad

doi:10.29054/apmc/2023.1361

Naseem Akhter Associate Professor, Department of Pathology, Multan Medical and Dental College, Multan Pakistan
Ahmed Raza Khan Specialist, Department of Medicine, Burjeel Medical Centre, Muscat, Oman
Hussain Farooq Senior Demonstrator, Department of Hematology, Shaikh Zayed Hospital, Lahore Pakistan
Shazia Maqbool Senior Medical Officer, Department of Cardiology, Mukhtar A Sheikh Memorial Welfare Hospital, Multan Pakistan
Namra Mahmood Assistant Professor, Department of Hematology / Pathology, Central Park Medical College, Lahore Pakistan
Afra Samad Professor, Department of Pathology, Multan Medical and Dental College, Multan Pakistan

DOI: https://doi.org/10.29054/apmc/2023.1361

Keywords: Neutrophil, Neutrophil / Lymphocyte ratio, ST segment elevation myocardial infarction, Complications

Abstract

Background: It is suggested that neutrophil infiltrate the infarcted zone. These cause leukocytes mediated hypercoagulable state by causing platelet activation and aggregation into the microcirculation. Thus, causing no reflow and increase the infarcted area. Among complete blood count white blood cell count, neutrophil count and neutrophil/lymphocyte ratio has been proposed to predict the mortality and outcome in coronary artery disease. Objective: Efficacy of total Neutrophil Count and Neutrophil/Lymphocyte Ratio in Predicting In-Hospital Mortality and complications after St Segment Elevation Myocardial Infarction. Study Design: Cross sectional observational study. Settings: Coronary care unit, Ibn-Siena Hospital, Multan Pakistan. Duration: September 2021 to October 2021. Methods: 159 patients with ST segment elevation myocardial infarction. It’s a cross sectional observational study conducted in the Coronary care unit, Ibn-Siena Hospital, Multan Pakistan after taking approval from ethical committee. Sampling Technique was nonprobability, consecutive sampling. Patients of both genders presented to coronary care unit with acute ST segment elevation myocardial infarction will be included. Numerical variables were presented by mean ±SD. Chi square test was used for categorical variables. Student t test was used for numerical data. A p value of <0.05 was considered significant. Results: Neutrophil/lymphocyte ratio has a significant relation with in-hospital mortality and complication like arrhythmias, pericarditis and total white blood count was significantly associated with cardiogenic shock. Binary regression analysis revealed that Neutrophil lymphocyte ratio is an independent predictor of mortality (OR 1.535, CI 0.967-2.434 and p value of 0.049). Conclusion: Patients with STEMI with high white blood cell count and neutrophil lymphocytes ratio are at increased risk of in hospital death.