Neutrophil to lymphocyte ratio (NLR) prognostic effects on heart failure; a systematic review and meta-analysis
Abstract Background Neutrophil to lymphocyte ratio (NLR), as a recent inflammatory index, has been reported to be a prognostic tool in different diseases. However, implication of this ratio in heart failure (HF) is less investigated. In this systematic review and meta-analysis, we aimed to assess th...
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-023-03572-6 |
| _version_ | 1797578272455786496 |
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| author | Mehrbod Vakhshoori Sepehr Nemati Sadeq Sabouhi Behzad Yavari Mehrnaz Shakarami Niloofar Bondariyan Sayed Ali Emami Davood Shafie |
| author_facet | Mehrbod Vakhshoori Sepehr Nemati Sadeq Sabouhi Behzad Yavari Mehrnaz Shakarami Niloofar Bondariyan Sayed Ali Emami Davood Shafie |
| author_sort | Mehrbod Vakhshoori |
| collection | DOAJ |
| description | Abstract Background Neutrophil to lymphocyte ratio (NLR), as a recent inflammatory index, has been reported to be a prognostic tool in different diseases. However, implication of this ratio in heart failure (HF) is less investigated. In this systematic review and meta-analysis, we aimed to assess the potential impact of NLR on HF clinical outcomes. Methods Relevant English published records in PubMed, Scopus, Embase, and Web of Science were screened up to July 2023. Articles reporting clinical outcomes (follow-up or in-hospital mortality, readmission, HF prediction, extended hospital stay length, pulmonary vascular resistance, atrial fibrillation, renal disease and functional capacity) in HF sufferers were collected for further analysis with addition of NLR difference stratified by death/survived and HF status. Results Thirty-six articles (n = 18231) were finally selected which reported NLR in HF sufferers (mean: 4.38, 95% confidence interval (CI): 4.02–4.73). We found 25 articles reported NLR and total mortality (either follow-up death (N = 19): 4.52 (95% CI: 4.03–5.01) or in-hospital death (N = 10): 5.33 (95% CI: 4.08–6.57)) with mean NLR of 4.74 (95% CI: 4.28–5.20). NLR was higher among deceased patients compared to survived ones (standard mean difference: 0.67 (95% CI: 0.48–0.87), P < 0.001)). NLR was found to be related with higher mortality risk (continuous variable: hazard ratio (HR): 1.12, 95% CI: 1.02–1.23, P = 0.013), categorical variable: HR: 1.77, 95% CI: 1.27–2.46, P = 0.001, T2 vs. T1: HR:1.56, 95%CI: 1.21–2.00, P = 0.001, T3 vs. T1: HR:2.49, 95%CI: 1.85–3.35, P < 0.001). Other aforementioned variables were not feasible to analyze due to presence of few studies. Conclusions NLR is a simple and acceptable prognostic tool for risk stratification and prioritizing high risk patients in clinical settings, especially in resource limited nations. |
| first_indexed | 2024-03-10T22:20:36Z |
| format | Article |
| id | doaj.art-b958d18199f14725805997c429b61c91 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-03-10T22:20:36Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-b958d18199f14725805997c429b61c912023-11-19T12:18:26ZengBMCBMC Cardiovascular Disorders1471-22612023-11-0123112210.1186/s12872-023-03572-6Neutrophil to lymphocyte ratio (NLR) prognostic effects on heart failure; a systematic review and meta-analysisMehrbod Vakhshoori0Sepehr Nemati1Sadeq Sabouhi2Behzad Yavari3Mehrnaz Shakarami4Niloofar Bondariyan5Sayed Ali Emami6Davood Shafie7Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical SciencesSchool of Medicine, Tehran Azad University of Medical SciencesStudent Research Committee, School of Medicine, Isfahan University of Medical SciencesCardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical SciencesHeart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical SciencesDepartment of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical SciencesHeart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical SciencesHeart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical SciencesAbstract Background Neutrophil to lymphocyte ratio (NLR), as a recent inflammatory index, has been reported to be a prognostic tool in different diseases. However, implication of this ratio in heart failure (HF) is less investigated. In this systematic review and meta-analysis, we aimed to assess the potential impact of NLR on HF clinical outcomes. Methods Relevant English published records in PubMed, Scopus, Embase, and Web of Science were screened up to July 2023. Articles reporting clinical outcomes (follow-up or in-hospital mortality, readmission, HF prediction, extended hospital stay length, pulmonary vascular resistance, atrial fibrillation, renal disease and functional capacity) in HF sufferers were collected for further analysis with addition of NLR difference stratified by death/survived and HF status. Results Thirty-six articles (n = 18231) were finally selected which reported NLR in HF sufferers (mean: 4.38, 95% confidence interval (CI): 4.02–4.73). We found 25 articles reported NLR and total mortality (either follow-up death (N = 19): 4.52 (95% CI: 4.03–5.01) or in-hospital death (N = 10): 5.33 (95% CI: 4.08–6.57)) with mean NLR of 4.74 (95% CI: 4.28–5.20). NLR was higher among deceased patients compared to survived ones (standard mean difference: 0.67 (95% CI: 0.48–0.87), P < 0.001)). NLR was found to be related with higher mortality risk (continuous variable: hazard ratio (HR): 1.12, 95% CI: 1.02–1.23, P = 0.013), categorical variable: HR: 1.77, 95% CI: 1.27–2.46, P = 0.001, T2 vs. T1: HR:1.56, 95%CI: 1.21–2.00, P = 0.001, T3 vs. T1: HR:2.49, 95%CI: 1.85–3.35, P < 0.001). Other aforementioned variables were not feasible to analyze due to presence of few studies. Conclusions NLR is a simple and acceptable prognostic tool for risk stratification and prioritizing high risk patients in clinical settings, especially in resource limited nations.https://doi.org/10.1186/s12872-023-03572-6Neutrophil to lymphocyte ratioHeart failurePrognosisMortalitySystematic reviewMeta-analysis |
| spellingShingle | Mehrbod Vakhshoori Sepehr Nemati Sadeq Sabouhi Behzad Yavari Mehrnaz Shakarami Niloofar Bondariyan Sayed Ali Emami Davood Shafie Neutrophil to lymphocyte ratio (NLR) prognostic effects on heart failure; a systematic review and meta-analysis BMC Cardiovascular Disorders Neutrophil to lymphocyte ratio Heart failure Prognosis Mortality Systematic review Meta-analysis |
| title | Neutrophil to lymphocyte ratio (NLR) prognostic effects on heart failure; a systematic review and meta-analysis |
| title_full | Neutrophil to lymphocyte ratio (NLR) prognostic effects on heart failure; a systematic review and meta-analysis |
| title_fullStr | Neutrophil to lymphocyte ratio (NLR) prognostic effects on heart failure; a systematic review and meta-analysis |
| title_full_unstemmed | Neutrophil to lymphocyte ratio (NLR) prognostic effects on heart failure; a systematic review and meta-analysis |
| title_short | Neutrophil to lymphocyte ratio (NLR) prognostic effects on heart failure; a systematic review and meta-analysis |
| title_sort | neutrophil to lymphocyte ratio nlr prognostic effects on heart failure a systematic review and meta analysis |
| topic | Neutrophil to lymphocyte ratio Heart failure Prognosis Mortality Systematic review Meta-analysis |
| url | https://doi.org/10.1186/s12872-023-03572-6 |
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