Neutrophil to lymphocyte ratio predict mortality and major adverse cardiac events in acute coronary syndrome: A systematic review and meta-analysis

Objectives: Neutrophil to lymphocyte ratio (NLR) might be associated with the mortality or major adverse cardiac events (MACEs) in acute coronary syndrome (ACS) patients. We performed a meta-analysis to evaluate the correlation between NLR and mortality/MACEs in ACS. Methods: We assessed clinical trials through Pubmed, EMBASE, the Cochrane Library and Web of science in investigating the association between NLR and mortality/MACEs in ACS patients up to August 15, 2017. The primary outcome was mortality or recurrent MACEs. Results: In total, 8 studies of 9406 patients were included in the systematic and meta-analysis. Our analysis indicated that elevated pretreatment NLR was a poor prognostic marker for patients with recent ACS in predicting medium to long-term mortality/MACEs (OR 1.26, 95% CI 1.13-1.41). And the analysis indicated that higher pretreatment NLR value was associated with higher in-hospital mortality in ACS patients (OR 6.39, 95% CI 1.49-27.38, p < 0.001). The NLR value of 5.0 maybe a cut-off value for ACS risk. Conclusions: In patients with a recent ACS, an elevated pretreatment NLR value is effective in predicting the risk of mortality/MACEs.