Correlation between Neutrophil-to-Lymphocyte Ratio and Echocardiographic Changes in Patients with Acute Coronary Syndrome

Abstract

Objectives: The aim of this study was to investigate the relationship between the Neutrophil-to-Lymphocyte Ratio (NLR) and electrocardiogram (ECG) changes in patients diagnosed with Acute Coronary Syndrome (ACS). Methodology: This cross-sectional study was conducted between December 2021 and March 2022, enrolling a total of 150 ACS patients. These participants were selected from the Punjab Institute of Cardiology, Gulab Devi Hospital's Cardiac Emergency, and the Medical Intensive Care Unit in Lahore, Pakistan. Electrocardiography, a non-invasive diagnostic tool, was used to assess cardiac electrical activity. The XP 300 SYSMAX fully automated Hematological Analyzer was employed to measure Neutrophil and Lymphocyte counts from blood samples. Results: The analysis revealed a weak positive correlation between the ECG changes and NLR (r = 0.069), which was statistically non-significant (p = 0.399), indicating no meaningful relationship between the two variables. Conversely, a moderate positive correlation (r = 0.388) was observed between NLR and adverse cardiac events, with a highly significant p-value of 0.00, suggesting that higher NLR levels may be associated with an increased risk of adverse outcomes. The relationship between ECG abnormalities and unfavorable cardiac events showed a weak positive correlation (r = 0.123), with a p-value of 0.135, further supporting the absence of a significant predictive link. Conclusion: The study found no statistically significant relationship between ECG abnormalities and adverse cardiac events in ACS patients. However, the Neutrophil-to-Lymphocyte Ratio (NLR) emerged as a significant marker of acute inflammation in the coronary vessels, suggesting its potential role in risk stratification and outcome prediction for ACS patients.