Utilidad clínica del Índice Neutrófilo-Linfocitos para la predicción de la enfermedad multivaso en pacientes con STEMI: Un estudio de corte transversal, retrospectivo

Carlos Alberto Chang Moran; Gonzalo Andre Banchon Macias; Gustavo Andres Varas Mera; Diego Vásquez Cedeño

doi:10.61708/c9k8ze18

Authors

Carlos Alberto Chang Moran Facultad de Ciencias de la Salud, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador Author https://orcid.org/0009-0007-1164-0846
Gonzalo Andre Banchon Macias Facultad de Ciencias de la Salud, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador Author https://orcid.org/0009-0009-5178-809X
Gustavo Andres Varas Mera Facultad de Ciencias de la Salud, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador Author https://orcid.org/0009-0003-0057-3546
Diego Vásquez Cedeño Facultad de Ciencias de la Salud, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador Author https://orcid.org/0000-0002-4849-6581

DOI:

https://doi.org/10.61708/c9k8ze18

Keywords:

ST Elevated Myocardial Infarction, Coronary Artery Disease, Neutrophil, Lymphocyte count, Prognosis

Abstract

Introduction: Studies have shown that an elevated neutrophil-lymphocyte ratio (NLR) is associated with cardiovascular events. Given the limited local availability of diagnostic-therapeutic resources to offer immediate adequate management of patients with coronary syndrome, NLR could be a low-cost predictor marker to identify patients with multiple coronary vessel involvement. Objective: To demonstrate the diagnostic utility of NLR for identifying multivessel disease (MVD) in patients with STEMI. Materials and methods: A retrospective cross-sectional study was conducted in patients with STEMI who underwent reperfusion therapy between 2020 and 2023. The association of serum inflammation parameters (neutrophils, lymphocytes, NLR, and US troponin T) with the presence of MVD determined by coronary angiography was assessed. Independent factors associated with MVD were also studied. ROC curves were performed to assess sensitivity and specificity and optimal cut-off points to predict the presence of MVD. Results: A slight increase in NLR was observed in people with MVD, although it was not statistically significant (p = 0.648). A NLR value of 2.075 was determined as a cut-off to predict MVD (sensitivity 94.1%, specificity 90%, AUC = 0.568). Multiple regression analysis did not determine independent factors associated with MVD. Conclusions: NLR was not related to a higher incidence of MVE in patients with STEMI. Therefore, inflammatory markers were not useful to predict the presence of MVD in patients admitted for STEMI.

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