The use of Neutrophil Lymphocyte Ratio in Patients Presenting to the Emergency Department with Chest Pain

Year 2021, Volume: 13 Issue: 3, 594 - 600, 18.10.2021

Atakan Savrun , Şeyda Savrun

https://doi.org/10.18521/ktd.934951

Abstract

Objective: Objective: In this study, we aimed to determine the roles of neutrophil, MPV, and NLR, in the diagnosis of ACS and the differentiation of ACS subtypes (ST-elevation myocardial infarction and non-ST elevation myocardial infarction), in patients presented to the emergency department with chest pain and were diagnosed with ACS (acute coronary syndrome).
Methods: This study was designed as a single-center, cross-sectional, and retrospective. 402 patients who were applied to University Hospital Emergency Department between January 2020 and November 2020; and registered to hospital automation system with chest pain; and underwent further examinations and treatments were included in the study. Ethical approval was obtained from the Local Clinical Research Ethics Committee before the study. Patients who were hospitalized after further examination, who received medical treatment, and did not undergo PCI (Percutaneous coronary intervention) were accepted as NSTMI (n = 202). Patients who were hospitalized after further examination and underwent PCI were accepted as STMI (n = 200).
Results: 36.3% of the patients were female (n = 146) and 63.7% (n = 256) were male. The mean age of the cases was detected to be 61.46 ± 14.06. The number of hospitalized ACS patients for NSTMI suspicion and received medical treatment was 202. The number of patients who underwent PCI and accepted as STMI was 200.Mean neutrophils, MPV, NLR, and Troponin values were also significantly higher than those who are not hospitalized (p <0.001). The mean WBC, Neutrophil, NLR, and Troponin values of the patients underwent PCI were also significantly higher than those without PCI (p <0.001).
Conclusion: We believe that NLR is a diagnostic valuable that can be used as a biomarker in diagnosing ACS and determining the PCI.

Keywords

Emergency Department, Chest Pain, Acute coronary syndrome, percutaneous coronary intervention, Neutrophil lymphocyte ratio

Acil Servise Göğüs Ağrısı ile Başvuran Hastalarda Nötrofil Lenfosit Oranının Kullanımı

Abstract

Amaç: Biz çalışmamızda acil servise göğüs ağrısı şikayeti ile başvuran ve AKS(Akut koroner sendrom) öntanısı alan olgularda; Nötrofil, MPV, NLR, nin AKS tanısı koymada ve AKS subtip ayrımını (ST elevasyonlu myokard enfarktüsüve non St elevasyonlu myokard enfarktüsü) yapabilme durumunu saptamayı amaçlanmıştır.
Yöntem: Bu çalışma tek merkezli, kesitsel ve retrospektif olarak yapıldı. Çalışmaya Üniversite hastanesi acil servisinin 2020-Ocak, 2020-Kasım tarihleri arasında hastane otomasyon sistemine göğüs ağrısı tanısı girilip ileri tetkik ve tedavi yapılan 402 hasta dahil edilmiştir. Çalışma için öncesinde Lokal Klinik Araştırmalar Etik Kurulu’ndan etik onay alındı. İleri tetkik sonrasında hastaneye yatışı yapılan, medikal tedavi alan ve PCI (Perkütan koroner girişim) yapılmayan olgular NSTMI olarak (n=202) kabul edilmiştir. İleri tetkik sonrasında hastaneye yatan ve PCI yapılan olgular STMI (n=200) olarak kabul edilmiştir.
Bulgular: Hastaların %36.3’ü kadın (n=146), %63.7’si (n=256) erkek olarak saptandı. Olguların yaş ortalaması 61.46±14.06 olarak tespit edildi. Hastaneye yatan AKS düşünülen olgulardan NSTMI düşünülen ve medikal tedavi ile alan hasta sayısı 202 iken, PCI tedavisi uygulanan ve STMI kabul edilen olgu sayısı 200 olarak saptanmıştır. Nötrofil, MPV, NLR ve Troponin ortalamaları da yatış yapmayanlardan anlamlı derecede yüksekti (p<0.001). PCI yapılan hastaların WBC, Nötrofil, NLR ve Troponin ortalamaları da PCI yapılmayanlardan anlamlı derecede yüksekti (p<0.001).
Sonuç: AKS tanısı konmasında ve PCI tedavi yönteminin belirlenmesinde NLR’ nin tanı değeri olan bir biyobelirteç olarak kullanılabileceği kanaatindeyiz.

Keywords

Acil Servis, Göğüs Ağrısı, Akut koroner sendrom, Perkütan koroner girişim, Nötrofil lenfozit oranı

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