World Journal of Cardiovascular Diseases, 2018, 8, 265-275 http://www.scirp.org/journal/wjcd ISSN Online: 2164-5337 ISSN Print: 2164-5329 DOI: 10.4236/wjcd.2018.85026 May 28, 2018 265 World Journal of Cardiovascular Diseases Predictive Value of Neutrophil-to-Lymphocyte Ratio in Outcomes of Patients with Acute Coronary Syndrome Wassam Eldin Hadad El Shafey 1* , Ahmed Mohamed Emara 1 , Walaa Farid Mosa 1 , Khaled Hussein El-Sharnouby 2 1 Department of Cardiology, Menoufia University Hospitals, Menoufia, Egypt 2 Department of Cardiology, Shibin El Kom Teaching Hospital, Menoufia, Egypt Abstract Objectives: Previous studies have demonstrated the role of inflammation in acute coronary syndrome (ACS). The neutrophil-to-lymphocyte ratio (NLR) was found to be a useful inflammatory marker for predicting adverse out- comes. We hypothesized that an elevated neutrophil-to-lymphocyte ratio would be associated with increased mortality in patients with acute coronary syndrome. Methods: The study consisted of 40 patients with acute coronary syndrome who were admitted to Cardiology Department—Menoufia Univer- sity Hospitals. The primary endpoint was all-cause in-hospital as well as 30-day mortality, and the patients were divided into three tertiles according to their admission NLR results. Results: All-cause 30-day mortality in the three groups based on NLR was 0.0%, 7.7% and 28.6%, in the low-, middle- and high-NLR groups, respectively (P < 0.05; χ 2 test). In a logistic regression anal- ysis, including baseline demographic, clinical, and biochemical covariates, the neutrophil-to-lymphocyte ratio was an independent predictor of mortality (OR = 2.44, 95% CI = 1.185 - 5.007, P < 0.05). Conclusion: An elevated neu- trophil-to-lymphocyte ratio (NLR), a simple, relatively inexpensive and un- iversally available inflammatory marker, seems to be a predictor of 30-day mortality in patients with acute coronary syndrome. Keywords Acute Coronary Syndrome, Inflammation, Ischemia, Neutrophil-to-Lymphocyte Ratio, Mortality 1. Introduction Many factors including diabetes, hypertension, smoking and dyslipidemia, all of How to cite this paper: El Shafey, W.E.H., Emara, A.M., Mosa, W.F. and El-Sharnouby, K.H. (2018) Predictive Value of Neutro- phil-to-Lymphocyte Ratio in Outcomes of Patients with Acute Coronary Syndrome. World Journal of Cardiovascular Diseases, 8, 265-275. https://doi.org/10.4236/wjcd.2018.85026 Received: April 2, 2018 Accepted: May 25, 2018 Published: May 28, 2018 Copyright © 2018 by authors and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Open Access