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Neutrophil-to-lymphocyte ratio predicts response to cardiac resynchronization therapy

Aysen Agacdiken, Umut Celikyurt, Tayfun Sahin, Kurtulus Karauzum, Ahmet Vural, Dilek Ural

Kocaeli, Turkey

Med Sci Monit 2013; 19:373-377

DOI: 10.12659/MSM.883915

Available online:

Published: 2013-05-17


Background: Neutrophil-to-lymphocyte (N/L) ratio has been associated with adverse outcomes in patients with acute coronary syndromes and increased risk for long-term mortality in patients with acute decompensated heart failure. We aimed to investigate the prognostic value of neutrophil-to-lymphocyte ratio on response to cardiac resynchronization therapy (CRT).
Material and Methods: Seventy consecutive patients (mean age 58±13 years; 40 men) undergoing CRT were included in the study. Hematological and echocardiographic parameters were measured before and 6 months after CRT. Echocardiographic response to CRT was defined as a ≥15% reduction in left ventricular end-systolic volume at 6-month follow-up.
Results: After 6 months of CRT, 49 (70%) patients were responders. After 6 months, left ventricular ejection fraction (LVEF) had significantly increased, from 21±7% to 34±11% in responder patients (p=0.001). N/L ratio decreased significantly, from 2.4±1 to 2.1±0.7 in responders (p=0.04). In multivariate analysis, significant associates of echocardiographic response to CRT was evaluated adjusting for age, etiology of cardiomyopathy, baseline LVEF, New York Heart Association functional class, C-reactive protein, and baseline N/L ratio. Baseline N/L ratio was the only predictor of response to CRT (OR 1.506, 95% CI, 1.011–2.243, p=0.035).
Conclusions: N/L ratio at baseline could help to identify patients with response to CRT.

Keywords: Lymphocytes - cytology, Leukocyte Count, Electrocardiography, cardiac resynchronization therapy, Neutrophils - cytology



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