Prognostic value of neutrophil-to-lymphocyte ratio in pulmonary arterial hypertension

• Published in: Journal of international medical research Vol. 43; no. 5; pp. 661 - 671
• Main Authors: Özpelit, Ebru, Akdeniz, Bahri, Özpelit, Mehmet Emre, Tas, Sedat, Bozkurt, Selen, Tertemiz, Kemal Can, Sevinç, Can, Badak, Özer
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-10-2015
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Cell Count; Demography; Female; Humans; Hypertension, Pulmonary - mortality; Hypertension, Pulmonary - pathology; Lymphocytes - cytology; Male; Middle Aged; Multivariate Analysis; Neutrophils - cytology; Prognosis; Young Adult; Pulmonary arterial hypertension; inflammation; prognosis; biomarkers; survival
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060515589394

Objective
To evaluate the prognostic value of baseline neutrophil-to-lymphocyte ratio (NLR) in the prediction of long-term mortality in patients with pulmonary arterial hypertension (PAH).
Methods
This prospective study recorded NLR during initial diagnostic right-sided cardiac catheterization in adult patients with PAH. Demographic, clinical, laboratory and haemodynamic variables were compared by NLR tertile. Univariate and multivariate Cox regression analyses were used to determine whether NLR was independently associated with mortality.
Results
Adults with PAH (n = 101) were followed-up for mean ± SD 36.8 ± 23.6 months. The number of deaths, New York Heart Association functional capacity (NYHA FC), levels of brain natriuretic peptide (BNP) or C-reactive protein (CRP) and presence of pericardial effusion increased as the NLR tertile increased, but haemoglobin and tricuspid plane annular systolic excursion (TAPSE) decreased. On univariate analysis, high NLR values were associated with mortality, but on multivariate analysis, NLR did not remain an independent predictor of mortality. Baseline NYHA FC, TAPSE, BNP level and pericardial effusion were independent predictors of mortality.
Conclusions
NLR was correlated with important prognostic markers in PAH such as NYHA FC, BNP and TAPSE. This simple marker may be useful in the assessment of disease severity in patients with PAH.