Effect of cardiac rehabilitation on neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in ST elevation myocardial infarction patients

Effect of cardiac rehabilitation on neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in ST elevation myocardial infarction patients

Objectives: Cardiac rehabilitation is known to have positive effects on the inflammatory processes. Theneutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) were found to be indicativeof inflammation. The purpose of this study is to determine the effects of cardiac rehabilitation on the NLR andPLR ratios of ST elevation myocardial infarction (STEMI) patients.Methods: The study includes 101 STEMI patients that underwent primary percutaneous coronary intervention(PCI). The patients were randomized into two groups: the cardiac rehabilitation group (CR group, n = 68), andthe control group (n = 33). One month after primary PCI, cardiac rehabilitation was applied to CR group withcycle ergometer for 8 weeks (30 sessions). The NLR and PLR parameters were calculated from the completeblood count results from before and after the cardiac rehabilitation application for both groups.Results: When the baseline values of the two groups were evaluated, the hemoglobin value of the controlgroup (13.10 ± 1.52 g/dL vs. 13.79 ± 1.26 g/dL; p = 0.03) and the PLR value of the CR group (122.50 ± 43.89vs. 92.41 ± 23.70; p = 0.001) were significantly higher. The post-cardiac rehabilitation complete blood countparameters, and the NLR and PLR values were similar in both groups. The NLR (3.11 ± 1.95 vs 2.39 ± 1.03;p = 0.003) and PLR (122.50 ± 43.89 vs. 108.68 ± 41.83; p = 0.025) parameters significantly decreased afterthe cardiac rehabilitation application in the CR group, whereas there wasn't a change in the control group.Conclusion: It was found that cardiac rehabilitation applied in STEMI patients caused a significant decreasein NLR and PLR parameters, which are indicators of inflammation.

___

  • [1] Eren M, Özpelit E, Aytemiz F, Güngör H, Güneri S. [Neutrophil to lymphocyte ratio on admission: is a predictor of cardiovascular outcome in patients with acute coronary syndrome as it predicts mortality?]. Koşuyolu Heart J 2014;17:153-8. [Article in Turkish]
  • [2] Goble AJ, Worcester MUC. Best practice guidelines for cardiac rehabilitation and secondary prevention. Heart Research Center. Melbourne, on behalf of Department of Human Services Victoria; Australia, 1999. www.health.vic.gov.au
  • [3] Yılmaz Ö. [Acute myocardial infarction with ST-elevation]. J Exp Clin Med 2012;29:S123-5. [Article in Turkish]
  • [4] Nilsson L, Wieringa WG, Pundziute G, Gjerde M, Engvall J, Swahn E, et al. Neutrophil/lmphocyte ratio is associated with non-calcified plaque burden in patients with coronary artery disease. PLoS One 2014;9:e108183.
  • [5] Zhang S, Diao J, Qi J, Jin J, Li L, Gao X, et al. Predictive value of neutrophil to lymphocyte ratio in patients with acute ST segment elevation myocardial infarction after percutaneous coronary intervention: a meta-analysis. BMC Cardiovasc Disord 2018;18:75.
  • [6] Sawant AC, Adhikari P, Narra SR, Srivatsa SS, Mills PK, Srivatsa SS. Neutrophil to lymphocyte ratio predicts short- and long-term mortality following revascularization therapy for ST elevation myocardial infarction. Cardiol J 2014;21:500-8.
  • [7] Azab B, Shah N, Akerman M, McGinn Jr JT. Value of platelet/lymphocyte ratio as a predictor of all-cause mortality after non-ST-elevation myocardial infarction. J Thromb Thrombolysis 2012;34:326-34.