Association of Increased Neutrophil to Lymphocyte Ratio to in-Hospital Outcome of Acute anterior Myocardial Infarction Patients Subjected to Thrombolytic Therapy with Streptokinase

Abstract

Background: Myocardial infarction mainly contributes to morbidity and mortality around the globe. Thrombolytic therapy with streptokinase is the primary treatment strategy for patients with the presentation of ST-segment-elevated acute myocardial Infarction. 
Objective: To assess to assess the correlation between increased NLR and in-hospital outcome in acute anterior MI patients subjected to streptokinase therapy.
Material and Methods: The study was a retrospective cohort conducted over a period of six months from 01, 06, 2021 to 30, 11, and 2021. All the patients admitted consecutively during this period received streptokinase therapy. The patients were grouped with respect to NLR, i.e., high NLR ang low NLR. The cut-off point for dividing into these two groups was set as 4.50 as an average of studies previously conducted. The study endpoints in-hospital outcomes and the secondary end point was short-term mortality.
Results: A total of 250 patients were presented with acute MI. Complications were reported in 115 patients (46%) whereas 46 deaths (18.4%) were reported. More complications were reported in patients present in the group with higher NLR, (n=83 vs. 27, 62.8 % vs. 22.8 %, p <0.0001), as well as death (n=35 vs. 11, 26.5 % vs. 9.3 %, p<0.0001) in hospital compared to the group with lower NLR. 
Conclusion: high NLR (using 4.50 as cut-off value) is in association with a higher rate of complicatxions and death during stay in the hospital in acute MI patients which are subjected to streptokinase. 
Key Words: Myocardial infarction, Thrombolytic therapy, Streptokinase, Neutrophil, Lymphocyte.