Neutrophil-Lymphocyte Ratio in Patients with Acute Myocardial Infarction: A Retrospective Study

Abstract

Objectives: Atherosclerotic coronary artery disease (CAD), particularly acute coronary syndrome (ACS), remains a leading cause of mortality worldwide. White blood cell (WBC) count is a widely used inflammatory marker in clinical practice due to its accessibility, ease of interpretation, and cost-effectiveness. The neutrophil-to-lymphocyte ratio (NLR) has been recognized as a predictive biomarker in various diseases, including cardiovascular conditions. This retrospective study aimed to evaluate the role of NLR as a prognostic marker in patients with acute myocardial infarction (AMI). Methodology: A retrospective analysis was conducted from June 2021 to February 2023, including 125 patients diagnosed with ACS at Sharourah General Hospital. Among them, 47 had ST-elevation myocardial infarction (STEMI) and 78 had non-ST elevation myocardial infarction (NSTEMI). Patient data were retrieved using the hospital information system (HIS), including demographic details, laboratory findings, and clinical parameters. Results: Comparison between the STEMI and NSTEMI groups revealed significant differences in NLR, troponin, WBC count, neutrophils, monocytes, CK-MB, AST, and HDL levels (P < 0.05). Notably, the STEMI group, characterized by a higher inflammatory burden, exhibited significantly elevated NLR compared to the NSTEMI group. Receiver operating characteristic (ROC) analysis identified an NLR cut-off value of > 4.17, with a sensitivity of 53.19% and specificity of 83.33% for predicting STEMI. Conclusion: NLR is a promising inflammatory biomarker that may aid in the early diagnosis and risk stratification of AMI. Its routine use in clinical practice could enhance the identification of high-risk patients and improve management strategies.