Predictive value of neutrophil-to-lymphocyte ratio in coron-ary chronic total occlusion patientsOA

BACKGROUND The neutrophil to lymphocyte ratio(NLR)has been reported as a novel predictor for atherosclerosis and car-diovascular outcomes.This study aimed to determine the effects of NLR on long-term clinical outcomes of chronic total occlusion(CTO)patients. METHODS A total of 670 patients with CTO who met the inclusion criteria were included at the end of the follow-up period.Patients were divided into tertiles according to their baseline NLR levels at admission:low(n=223),intermediate(n=223),and high(n=224).The incidence of major adverse cardiac events(MACEs)during the follow-up period,including all-cause death,nonfatal myocardial infarction(MI),or ischemia-driven revascularization,were compared among the three groups. RESULTS Major adverse cardiac events were observed in 27 patients(12.1％)in the low tertile,40(17.9％)in the intermediate tertile,and 61(27.2％)in the high NLR tertile(P＜0.001).Kaplan-Meier analysis demonstrated a significantly higher incidence of MACE,ischemia-driven coronary revascularization,non-fatal MI,and mortality in patients within the high tertile than those in the low and intermediate groups(all P＜0.001).Multivariable COX regression analysis showed that the high tertile of baseline NLR level showed a strong association with the risk of MACE(hazard ratio[HR]=2.21;95％confidence interval[CI]:1.21-4.03;P=0.009),ischemia-driven coronary revascularization(HR=3.19;95％CI:1.56-6.52;P=0.001),MI(HR=2.61;95％CI:1.35-5.03;P=0.043)and mortality(HR=3.78;95％CI:1.65-8.77;P=0.001). CONCLUSION Our findings suggest that NLR is an inexpensive and readily available biomarker that can independently pre-dict cardiovascular risk in patients with CTO.