Korean Circ J.  2016 Nov;46(6):768-773. 10.4070/kcj.2016.46.6.768.

Neutrophil Lymphocyte Ratio as a Predictor of Left Ventricular Apical Thrombus in Patients with Myocardial Infarction

• Ertem AG
• Ozcelik F
• Kasapkara
• Koseoglu C
• Bastug S
• Ayhan H
• Sari C
• Akar Bayram N
• Bilen E
• Durmaz T
• Keles T
• Bozkurt E

• KMID: 2355451
• DOI: http://doi.org/10.4070/kcj.2016.46.6.768

Abstract

BACKGROUND AND OBJECTIVES
In this study, we examined the role of inflammatory parameters in an apical mural thrombus with a reduced ejection fraction due to large anterior myocardial infarction (MI).
SUBJECTS AND METHODS
A total of 103 patients who had suffered from heart failure, 45 of whom had left ventricular apical thrombus (AT) after a large anterior MI, were enrolled in the study. A detailed clinical history was taken of each participant, biochemical inflammatory markers, which were obtained during admission, were analyzed and an echocardiographical and angiographical evaluation of specific parameters were performed.
RESULTS
There were no statistically significant differences in terms of age, gender, and history of hypertension, diabetes mellitus, and atrial fibrillation between both groups (p>0.05). Similarly there were no statistically significant differences in terms of biochemical and echocardiographic parameters (p>0.05). However, there were significant differences in terms of neutrophil lymphocyte ratio (p=0.032). After a multivariate regression analysis, neutrophil lymphocyte ratio (NLR) was an independent predictor of thrombus formation (β: 0.296, p=0.024). The NLR >2.74 had a 78% sensivity and 61% specifity in predicting thrombus in patients with a low left ventricular ejection fraction.
CONCLUSION
In this study, neutrophil lymphocyte ratios were significantly higher in patients with apical thrombus.

Keyword

Inflammation; Thrombus; Myocardial infarction

MeSH Terms

Atrial Fibrillation
Diabetes Mellitus
Echocardiography
Heart Failure
Humans
Hypertension
Inflammation
Lymphocytes*
Myocardial Infarction*
Neutrophils*
Stroke Volume
Thrombosis*

Figure

• 

  Fig. 1 Sensitivity and specificity of neutrophil lymphocyte ratios for apical thrombus. ROC: receiver operating characteristic, AUC: area under curve, CI: confidence interval.

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