The Relationship between neutrophil-to-lymphocyte ratio and fragmented QRS in acute STEMI patients treated with primary PCI

Background: No study so far investigated fragmented QRS (fQRS) and neutrophil-to-lymphocyte ratio (NLR) together in ST segment elevation myocardial infarction (STEMI). Objective: To investigate the relationship between NLR and fQRS, and determine the prognostic significance of the combined use of these two parameters in STEMI. Methods: We included 368 patients with first acute STEMI who successfully revascularized with primary percutaneous coronary intervention. Results: Patients with IQRS had significantly higher NLR, and in-hospital mortality rate compared to patients with no-fQRS. The best cut-off value of NLR to predict mortality was 5.47. Patients with NLR >= 5.47 had a higher frequency of fQRS and in-hospital mortality rate. Multivariate analysis showed that NLR was an independent predictor of the presence of fQRS (OR: 1.095, 95% CI: 1.039-1.153, P = 0.001). When patients were stratified by fQRS and cut-off value of NLR, in-hospital mortality gradually increased (P < 0.001). Conclusion: NLR is independently associated with the presence of fQRS in STEMI patients. Combined use of both parameters provides additional prognostic contribution for identifying patients at higher cardiac risk. (C) 2017 Elsevier Inc. All rights reserved.