Correlation Of Preoperation Neutrophil To Lymphocyte Ratio With Perioperative Outcomes In Patients In Coronary Artery Bypass Grafting Patients With AMI

ObjectiveTo study whether the neutrophil to lymphocyte ratio (NLR) is a reliable predicter for theoutcome of perioperative coronary artery bypass grafting (CABG) patients by observing thecorrelation of preoperation NLR with perioperative outcome in CABG patients with acutemyocardial infarction (AMI) at admission. This may provide some imformation for clinicalguidance.MethodsTwo hundred and ten CABG patients with AMI, were admitted from June2011to June2012. We collected age, sex, height, weight, history of hypertension, diabetes, hyperlipidemia,smoking history and other basic information. Then we meansured the peripheral white bloodcell and its subclasse at3days before operation and calculated the NLR. In addition, werecorded cardiac troponin I (cTnI), creatine kinase isoenzyme (CK-MB), the ICU maximumdwell time, postoperative low cardiac output, stroke, myocardial infarction, two thoracic andother clinical data at24hours after operation; Patients were divided into four groupsaccording to NLR (First group:0.96-1.78, Second group:1.79-2.33, Third group:2.34-3.18,Fourth group:3.19-9.78). Comparison of basic data of NLR patients among preoperative andpostoperative, and analyzed the correlation of perioperative outcome of NLR and CABGpatients with AMI after surgery by using the multiple stepwise regression analysis All the datawere analyzed by SPSS18.0, The p values <0.05was considered statistical significant..ResultsA total of210patients were entered into this study, including169male patients (80.5%),female41cases (19.5%), mean age (60.20±9.04years,range38-89years);124cases weresmoking patients (59%);58patients with diabetes mellitus (27.6%);121(57.6%) patients withhypertension; hyperlipemia in45patients (21.4%);54patients with ejection fraction <50%(25.7%), WBC(7.09±1.88)×109/L, L (1.87±0.57)×109/L, N (4.63±1.67)×109/L, NLR2.72±1.41.Following the elevated NLR levels, patients with history of hypertension and ejection fraction <50%ratio gradually increased, the comparison of group1and group4hadsignificant difference (P<0.05); the white blood cell count between Group1and Group4werestatistically significant (6.18±1.44and8.34±2.10)×109/L (P <0.001); the postoperativecTnI peak (1.86±1.36,2.92±2.10,5.03±4.84and15.32±12.87) ng/ml and postoperativeCK-MB peak (8.95±6.24,12.16±8.94,15.27±14.69and39.01±35.97) U/L werestatistically significant in the Group4(P <0.05), compared of postoperative serum creatininepeak (group1, group2, group3) and group4, the difference was statistically significant (P<0.05); the difference of postoperative ICU dwell time (20.28±11.51and37.76±30.19) hbetween Group1and Group4were statistically significant (P <0.05); following elevatedNLR levels, postoperative low cardiac output and at the two postoperative patientsundergoing thoracic ratio gradually increased, the comparison of group1and group4hadsignificant difference (P<0.05). Multiple stepwise regression analysis showed thatpreoperative NLR wes positively correlated with the peak value of cTnI and ICU afteroperation, the dwell time at the two postoperative thoracotomy (r=0.554, P<0.05; r=0.418,P<0.05; r=0.474, P<0.05).Conclusion1.The results of this study indicate that following elevated NLR levels, the adverseoutcomes of underwent CABG patients with AMI were increased, preoperative NLR maybecome a predictor in CABG patients with AMI.2.Preoperative elevated NLR is associated with poor perioperative outcomes ofunderwent CABG patients with AMI,preoperative NLR may become a predictor in CABGpatients withAMI.