Significance of Neutrophil to Lymphocyte Ratio in Acute St-Segment Elevation Myocardial Infarction

Neutrophil to Lymphocyte Ratio in Acute Myocardial Infarction

Abstract

Background: Myocardial infarction remains a leading cause of global mortality, necessitating reliable prognostic markers. This study evaluates the neutrophil-to-lymphocyte ratio (NLR) as a predictor of in-hospital complications in acute ST-elevation myocardial infarction (STEMI) patients in Pakistan, where research on NLR is limited. Objective: To determine the proportion of STEMI patients with high NLR (≥4.50) and compare complication rates between high- and low-NLR groups. Study Design: Descriptive study. Settings: Faisalabad Institute of Cardiology, Faisalabad Pakistan. Duration: July 30, 2022 to January 30, 2023. Methods: 385 STEMI patients. NLR was calculated from admission blood samples, and complications (arrhythmias, cardiogenic shock, heart failure, re-infarction and mortality) were recorded. Statistical analysis used SPSS v25, with p<0.05 considered significant. Results: Mean age was 52.95±7.85 years (47% male, 53% female). Mean NLR was 4.22±0.85; 43.4% had high NLR. High NLR correlated with higher complication rates: arrhythmias (67.5% vs. 25.0%, p=0.000), cardiogenic shock (58.6% vs. 39.1%, p=0.001), heart failure (79.0% vs. 32.5%, p=0.001), and mortality (33.1% vs. 14.2%, p=0.037). No significant difference was observed in re-infarction rates. Conclusion: High NLR is associated with increased in-hospital complications in STEMI patients, supporting its role as a cost-effective prognostic marker. Routine NLR assessment could aid early risk stratification and improve outcomes in resource-limited settings.