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RISS 인기검색어
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- 저자 : ( Felix Punzalan ) (검색결과 1 건)
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( Jaime Aherrera ),( Lowe Chiong ),( Paul Reganit ),( Felix Punzalan ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Patients with documented acute coronary syndromes (ACS) exhibit a wide spectrum of early risk of death. An elevated neutrophil count predicts a worse outcome in ACS. In contrast, a low lymphocyte count is related to high risks of adverse outcomes. The neutrophil-lymphocyte ratio (NLR), therefore, integrates for two WBC subtypes with opposite actions in terms of vascular infl ammation. Objectives: Among patients diagnosed with ACS, we aim to determine if an elevated NLR taken within 24 hours of admission is associated with higher rates of adverse outcomes. Methods: A prospective cohort of adult patients admitted with a diagnosis of ACS was conducted. The participants were stratifi ed into two: low to intermediate NLR (NLR < 6.5) and high NLR (NLR > 6.50). Primary outcome was in-hospital mortality. Secondary outcomes include development or worsening of congestive heart failure (CHF) and the development of cardiogenic shock, re-infarction, renal failure, pneumonia, and arrhythmias. Results: 117 patients with a mean age of 60 +/- 13 were included. Diagnosis on admission was unstable angina (28%), NSTEMI (40%), and STEMI (37%). Analysis of data showed that the odds of in-hospital deaths among those with a high NLR is 5.71 times higher compared to those with low-intermediate NLR [OR 5.71 (1.53-21.23, p 0.009)]. Using linear regression, the NLR of patients who were non-survivors was computed at 9.91, while the NLR of those who survived was 5.47. A high NLR was also predictive of the development or worsening of CHF, shock, re-infarction, arrhythmias, and development of any adverse outcome. Conclusion: Among patients with ACS, an elevated NLR (>6.5) taken within 24 hours of presentation is a useful marker to predict in-hospital mortality, development or worsening or CHF, and development of shock, re-infarction, and arrhythmias.
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