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Neutrophil to Lymphocyte (N/L) and Platelet to Lymphocyte (P/L) Ratios in Differentiating Acute Heart Failure from Respiratory Infection

[ Vol. 15 , Issue. 5 ]

Author(s):

Eftychios E. Siniorakis, Konstantinos Tsarouhas, Christina Tsitsimpikou, Theodora Ch. Batila, Stamatia Panta, Konstantinos G. Zampelis, Elias Rentoukas, Filippos Triposkiadis and Sotiria J. Limberi   Pages 477 - 481 ( 5 )

Abstract:


Background: The clinical manifestations of acute heart failure (AHF) and respiratory infection (RI) frequently overlap in patients presenting with dyspnoea at the emergency department (ED). The neutrophil to lymphocyte (N/L) and platelet to lymphocyte (P/L) ratios have been proposed as diagnostic and prognostic indices in this setting.

Objective: To evaluate the ability of N/L and P/L ratios to discriminate the cause of dyspnoea in patients admitted with an initial diagnosis of AHF-RI.

Methods: 100 consecutive dyspnoeic chronic heart failure (CHF) patients diagnosed as AHF-RI in the ED of Sotiria Chest Diseases General Hospital were monitored for a series of parameters. The diagnostic efficacy of the registered parameters in discriminating the AHF from RI patients was evaluated.

Results: The N/L and P/L ratios did not differ statistically depending on the pharmaceutical therapy applied in the study population, with the exception of furosemide and spironolactone-treated patients, who both had higher ratio values. In the AHF patients, only N/L was influenced by the pharmaceutical treatment administered. Patients with higher N/L ratio values were more likely to have RI-triggereddyspnoea (odds ratio, OR=1.35, 95% confidence interval-CI: 0.99-1.42, p=0.047). ROC curve (receiver operating characteristic curve) analysis revealed a significant ability of the N/L ratio to differentiate pure AHF from RI (area under the curve AUC=0.773, p<0.001, cut-off value N/L= 3.15).

Conclusion: The N/L ratio, a cheap and easily assessed biomarker, warrants further investigation as a potential diagnostic tool for the ED physician facing dyspnoeic CHF patients.

Keywords:

Acute heart failure, respiratory infection, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, CHF, WBC.

Affiliation:

Department of Cardiology, Sotiria Chest Diseases General Hospital, 152 Messogeion Av., Athens, 11527, Department of Cardiology, General University Hospital of Larissa, Terma Mezourlo, Larissa 41110, General Chemical State Laboratory of Greece, Department of Hazardous Substances, Mixtures & Articles,16 An. Tsocha Str., Athens115121, Department of Cardiology, Sotiria Chest Diseases General Hospital, 152 Messogeion Av., Athens, 11527, Department of Cardiology, Sotiria Chest Diseases General Hospital, 152 Messogeion Av., Athens, 11527, Department of Cardiology, Sotiria Chest Diseases General Hospital, 152 Messogeion Av., Athens, 11527, Department of Cardiology, Amalia Fleming General Hospital, 14 25th Martiou, Athens 15127, Department of Cardiology, General University Hospital of Larissa, Terma Mezourlo, Larissa 41110, Department of Cardiology, Sotiria Chest Diseases General Hospital, 152 Messogeion Av., Athens, 11527

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