Elevated neutrophil/lymphocyte ratio is associated with appropriate shock after ICD implantation [Artan nötrofil/lenfosit oranı ICD ımplantasyonu sonrası uygun şok ile ılişkilidir]

Abstract

Aim: Neutrophil/lymphocyte (N/L) ratio is associated with prognosis in cardiovascular diseases such as coronary artery disease, acute myocardial infarction, and heart failure (HF). However, its prognostic significance in HF patients with implantable cardioverter defibrillator (ICD) is unknown. The aim of this study was to evaluate the association between N/L ratio and the development of appropriate ICD shock in HF patients with implante ICD. Material and Method: A total of 58 consecutive HF patients with implanted ICD were enrolled into the study. According to the receiver operator characteristics curve analysis: optimal cut-off value of N/L ratio to predict appropriate ICD shock was found as >2.54, with 59.3% sensitivity and 87.1% specificity. Patients were categorized into two as lower (group I) or higher (group II) N/L ratio according to cut-off value of >2.54. Results: Mean age of patients was 60±10 years. ICD shock was observed in 27 (47%) patients. Among these 27 patients 11 (29%) patient was in Group I and 16 (80%) were in Group II (p<0.001). N/L ratio on admission, right ventricular dilatation, hemoglobin and hematocrit levels, systolic PA pressure and moderate to severe mitral regurgitation were found to have prognostic significance in univariate analysis. In multivariate logistic regression model, only N/L ratio (p=0.031, OR: 4.013, %95 CI: 1.135-14.180) remained associated with the development of ICD shock in HF patients with implanted ICD. Discussion: We demonstrated that higher N/L ratio was strongly independent predictor of appropriate ICD shock, independent of coronary heart disease risk factors in HF patients. © 2016, Journal of Clinical and Analytical Medicine. All rights reserved.