Abstract 14645: The Neutrophil to Lymphocyte Ratio Has the Long-Term Prognostic Value for the Prediction of Sudden Cardiac Death in Patients With Chronic Heart Failure, Irrespective of Ischemic or Non-Ischemic Origin
Backgrounds: The identification of patients at risk for sudden cardiac death (SCD) in patients with chronic heart failure (CHF) still remains an important goal. The neutrophil to lymphocyte ratio (NLR) has been associated with poor outcome in patients with acute coronary syndrome. However, there is no information available on the prognostic significance of NLR for predicting SCD in CHF patients, relating to the etiology (ischemic or non-ischemic).
Methods and Results: We studied 153 consecutive CHF outpatients (NYHA class: 2.0±0.6, ischemic 51%) with LVEF <40% (30±8%) in our prospective cohort study. These patients underwent complete blood counts with automated differential counts, which included total white blood cell count, neutrophils, lymphocytes, red cell distribution width (RDW) and platelet cell distribution width (PDW), at baseline. During a follow up period of 7.6±4.3 yrs, 28 patients had SCD. At multivariate Cox analysis, only NLR was independently and significantly associated with SCD in both ischemic and non-ischemic groups, although percent neurophil, percent lymphocyte, RDW or PDW showed a significant association with SCD at univariate analysis. Kaplan-Meier analysis showed that SCD was significantly observed in patients with high NLR (above the highest quartile) than low NLR, in ischemic (43% vs 14%, p=0.002) and non-ischemic groups (38% vs 8%, p=0.003). The adjusted hazard ratios of high NLR for predicting SCD in ischemic and non-ischemic groups were 3.46 (95%CI 1.04-11.49) and 3.72(95%CI 1.05-13.20), respectively.
Conclusion: NLR has the long-term prognostic value for the prediction of SCD in CHF patients, irrespective of the etiology.
- © 2013 by American Heart Association, Inc.