PMID- 35964050 OWN - NLM STAT- MEDLINE DCOM- 20220816 LR - 20220827 IS - 1475-2840 (Electronic) IS - 1475-2840 (Linking) VI - 21 IP - 1 DP - 2022 Aug 13 TI - High neutrophil to lymphocyte ratio with type 2 diabetes mellitus predicts poor prognosis in patients undergoing percutaneous coronary intervention: a large-scale cohort study. PG - 156 LID - 10.1186/s12933-022-01583-9 [doi] LID - 156 AB - BACKGROUND: Inflammation plays a crucial role in the pathogenesis and progression of coronary artery disease (CAD). The neutrophil to lymphocyte ratio (NLR) is a novel inflammatory biomarker and its association with clinical outcomes in CAD patients with different glycemic metabolism after percutaneous coronary intervention (PCI) remains undetermined. Therefore, this study aimed to investigate the effect of NLR on the prognosis of patients undergoing PCI with or without type 2 diabetes mellitus (T2DM). METHODS: We consecutively enrolled 8,835 patients with CAD hospitalized for PCI at Fuwai hospital. NLR was calculated using the following formula: neutrophil (*10(9)/L)/lymphocyte (*10(9)/L). According to optimal cut-off value, study patients were categorized as higher level of NLR (NLR-H) and lower level of NLR (NLR-L) and were further stratified as NLR-H with T2DM and non-T2DM, and NLR-L with T2DM and non-T2DM. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCEs), defined as all-cause mortality, myocardial infarction (MI), stroke and target vessel revascularization. RESULTS: A total of 674 (7.6%) MACCEs were recorded during a median follow-up of 2.4 years. The optimal cut-off value of NLR was 2.85 determined by the surv_cutpoint function. Compared to those in the NLR-H/T2DM groups, patients in the NLR-L/non-T2DM, NLR-H/non-T2DM and NLR-L/T2DM groups were at significantly lower risk of 2-year MACCEs [adjusted hazard ratio (HR): 0.67, 95% confidence interval (CI): 0.52 to 0.87, P = 0.003; adjusted HR: 0.62, 95%CI: 0.45 to 0.85, P = 0.003; adjusted HR: 0.77, 95%CI: 0.61 to 0.97, P = 0.025; respectively]. Remarkably, patients in the NLR-L/non-T2DM group also had significantly lower risk of a composite of all-cause mortality and MI than those in the NLR-H/T2DM group (adjusted HR: 0.57, 95%CI: 0.35 to 0.93, P = 0.024). Multivariable Cox proportional hazards model also indicated the highest risk of MACCEs in diabetic patients with higher level of NLR than others (P for trend = 0.009). Additionally, subgroup analysis indicated consistent impact of NLR on MACCEs across different subgroups. CONCLUSIONS: Presence of T2DM with elevated NLR is associated with worse clinical outcomes in CAD patients undergoing PCI. Categorization of patients with elevated NLR and T2DM could provide valuable information for risk stratification of CAD patients. CI - (c) 2022. The Author(s). FAU - He, Jining AU - He J AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167A Beilishi Road, Xi Cheng District, Beijing, 100037, China. FAU - Bian, Xiaohui AU - Bian X AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167A Beilishi Road, Xi Cheng District, Beijing, 100037, China. FAU - Song, Chenxi AU - Song C AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167A Beilishi Road, Xi Cheng District, Beijing, 100037, China. FAU - Zhang, Rui AU - Zhang R AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167A Beilishi Road, Xi Cheng District, Beijing, 100037, China. FAU - Yuan, Sheng AU - Yuan S AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. AD - Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167A Beilishi Road, Xi Cheng District, Beijing, 100037, China. FAU - Yin, Dong AU - Yin D AD - Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. FAU - Dou, Kefei AU - Dou K AD - State Key Laboratory of Cardiovascular Disease, Beijing, China. drdoukefei@126.com. AD - Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167A Beilishi Road, Xi Cheng District, Beijing, 100037, China. drdoukefei@126.com. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20220813 PL - England TA - Cardiovasc Diabetol JT - Cardiovascular diabetology JID - 101147637 SB - IM MH - Cohort Studies MH - *Coronary Artery Disease/diagnosis/etiology/therapy MH - *Diabetes Mellitus, Type 2/complications/diagnosis MH - Humans MH - Lymphocytes/pathology MH - *Myocardial Infarction/pathology MH - Neutrophils/pathology MH - *Percutaneous Coronary Intervention/adverse effects MH - Prognosis PMC - PMC9375260 OTO - NOTNLM OT - Coronary artery disease OT - Diabetes OT - Neutrophil‑to‑lymphocyte ratio OT - Percutaneous coronary intervention OT - Prognosis COIS- The authors declare that they have no competing interests. EDAT- 2022/08/14 06:00 MHDA- 2022/08/17 06:00 PMCR- 2022/08/13 CRDT- 2022/08/13 23:27 PHST- 2022/07/02 00:00 [received] PHST- 2022/07/25 00:00 [accepted] PHST- 2022/08/13 23:27 [entrez] PHST- 2022/08/14 06:00 [pubmed] PHST- 2022/08/17 06:00 [medline] PHST- 2022/08/13 00:00 [pmc-release] AID - 10.1186/s12933-022-01583-9 [pii] AID - 1583 [pii] AID - 10.1186/s12933-022-01583-9 [doi] PST - epublish SO - Cardiovasc Diabetol. 2022 Aug 13;21(1):156. doi: 10.1186/s12933-022-01583-9.