PROGNOSTIC VALUE OF NEUTROPHIL-TO-LYMPHOCYTE RATIO IN ACUTE CORONARY SYNDROME: A MARKER FOR DISEASE SEVERITY AND RISK STRATIFICATION

Abstract

Background and Objective: Acute coronary syndrome (ACS) is a major cause of cardiovascular-related death, accounting for 30% of mortality among over 35-year-olds. Inflammatory factors, including the neutrophil-to-lymphocyte ratio (NLR), significantly influence disease progression and outcomes. The study aimed to assess and establish NLR as a reliable biomarker for risk stratification in ACS patients.

Material and methods: This cross-sectional study, with a sample size of 70 patients, was conducted at Shifa International Hospital, Islamabad. The diagnosis of ACS was done using clinical assessment. Laboratory parameters were obtained from routine blood tests. All ACS patients received standard treatment following the Pakistan Cardiac Society and international guidelines. Data were analyzed using SPSS version 24, with quantitative variables and categorical variables compared. A logistic regression model was used to identify risk factors associated with mortality.

Results: The study population had a mean age of 38.18±1.39 years. The average neutrophil count was 5.81±1.08 (×10³/μL), the leukocyte count was 3.25±0.55 (×10³/μL), and the NLR was 2.55±1.00. The majority of patients were male (61.4%), with high rates of diabetes, and previous myocardial infarction (71.4%). The optimal cut-off for NLR was 2.5, providing a sensitivity of 62.1% and a specificity of 100%.

Conclusion: The study highlights NLR as a valuable risk stratification tool, supporting its role in early triage decisions for ACS patients in emergency settings.