Derived neutrophil-to-lymphocyte ratio as a predictor of no-reflow in ST-elevation myocardial infarction
BIOMARKERS IN MEDICINE, cilt.19, sa.21, ss.1037-1045, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 19 Sayı: 21
- Basım Tarihi: 2025
- Doi Numarası: 10.1080/17520363.2025.2590790
- Dergi Adı: BIOMARKERS IN MEDICINE
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Chemical Abstracts Core, EMBASE, MEDLINE
- Sayfa Sayıları: ss.1037-1045
- Ondokuz Mayıs Üniversitesi Adresli: Hayır
Özet
AimsThe no-reflow (NR) phenomenon is a serious complication of primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI), often reflecting distal embolization and microvascular obstruction, and representing a substrate for periprocedural (type 4a) myocardial infarction. NR has been linked to worse prognosis, including higher short- and long-term mortality. Inflammation is a key contributor to NR development. This study aimed to evaluate the relationship between the derived neutrophil-to-lymphocyte ratio (dNLR) and NR in STEMI patients undergoing PCI, and to assess its predictive value.MethodsThis retrospective, single-center observational study included consecutive STEMI patients undergoing primary PCI between May 2024 and May 2025. Patients were grouped based on post-procedural TIMI flow grade. Demographic, clinical, and laboratory parameters were compared. Regression and ROC analyses were performed.ResultsA total of 208 patients were analyzed, among whom no-reflow occurred in 26.4% (n = 55). The NR group had significantly higher dNLR, C-reactive protein (CRP), glucose, creatinine, and troponin levels, along with lower left ventricular ejection fraction (LVEF). dNLR, diabetes mellitus, CRP and LVEF were independent predictors of NR.ConclusiondNLR is a simple, cost-effective marker that may help identify patients at high risk of no-reflow in STEMI. Further prospective studies are warranted.