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Neutrophil to lymphocyte ratio (NLR) and cardiovascular diseases: an update
Abstract
As we know, inflammatory and oxidative stresses have a role in the pathogenesis of cardiovascular disease. This knowledge has triggered many investigations targeted to inflammatory markers. One such example, the neutrophil to lymphocyte ratio (NLR), is an inexpensive and easily accessible inflammatory marker whose role in cardiovascular disease has been studied extensively in the past few years. The neutrophil lymphocyte ratio has been shown to predict cardiac arrhythmias as well as short- and long-term mortality in patients with acute coronary syndromes (ACS). It has correlated well with ACS risk prediction models such as the GRACE and SYNTAX scores. A higher NLR has also been associated with frequent congestive heart failure decompensation and long-term mortality. The neutrophil to lymphocyte ratio also appears to have a prognostic role in patients undergoing transaortic valve replacement and the progression of valvular heart diseases. Despite the science of inflammatory biomarkers having been described decades ago, NLR appears to be enjoying a renaissance as a cost-effective biomarker with immediate clinical predictability and prognostication.
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“Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) are tests that can be easily measured using a complete blood count, can be used as markers of inflammatory processes in diseases such as autoimmune diseases, and have been shown to be prognostic indicators.3,4”
From Association Between Mood Disorder Severity, Treatment Response and Systemic Inflammatory Markers: Exploring the Role of NLR, PLR, MLR, and SII (2024) · cites this paper as [3]
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Cited by
Sorted by citations
Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in mood disorders: A meta-analysis
Mazza, M. G., Lucchi, S., Tringali, A. G. M., Rossetti, A., Botti, E. R., & Clerici, M. (2018) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2018.03.012 · Cited by 326
“Several researchers have proven that these ratios have the value to be used as biomarkers of poor prognosis or major inflammation among patients with chronic medical conditions such as cardiovascular diseases (Afari and Bhat, 2016; Li et al., 2017b), malignancies (Li et al.”
BackgroundMazza, M. G., Lucchi, S., Rossetti, A., & Clerici, M. (2020) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2019.1583371 · Cited by 191
“…cardiovascular diseases, malignancies, acute pancreatitis, autoimmune diseases, chronic obstructive pulmonary disease and metabolic syndrome-related conditions (Azab et al. 2011; Aydin et al. 2015; Kelly et al. 2015; Afari & Bhat 2016; Yang et al. 2017; Yao et al. 2017; Min et al. 2018).”
BackgroundHaybar, H., Pezeshki, S., & Saki, N. (2019) · Experimental and molecular pathology (Print) · doi:10.1016/j.yexmp.2019.104267 · Cited by 147
Erdoğan, M., Erdöl, M. A., Öztürk, S., & Durmaz, T. (2020) · Biomarkers in Medicine · doi:10.2217/bmm-2020-0274 · Cited by 128
Hemond, C. C., Glanz, B. I., Bakshi, R., Chitnis, T., & Healy, B. C. (2019) · BMC Neurology · doi:10.1186/s12883-019-1245-2 · Cited by 118
“The neutrophil-lymphocyte ratio (NLR) and monocyte-lymphocyte ratio (MLR) are inexpensive and readily available components of the standard complete blood count (CBC); they are increasingly recognized as clinically-relevant biomarkers of pathological inflammation across multiple areas of medicine including oncology [3,…”
Background
Metadata
- Authors
- Afari, M. E., & Bhat, T.
- Affiliations
- Tufts University (US)
- Corresponding author
- Bhat, Tariq
- ORCID
- Afari, Maxwell E.
- Venue
- Expert Review of Cardiovascular Therapy
- Publisher
- Informa UK Limited
- Published
- 2016-03-04
- Volume
- 14
- Issue
- 5
- Pages
- 573-577
- ISSN
- 1477-9072 (ISSN-L)
- 1744-8344
- OpenAlex
- W2285799691
- Cited by
- 439
- References
- 0
- Citations by year
- 2026: 31 · 2025: 48 · 2024: 55 · 2023: 63 · 2022: 72 · 2021: 63 · 2020: 46 · 2019: 26 · 2018: 19 · 2017: 10 · 2016: 6
- FWCI
- 2.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Expert Review of Cardiovascular Therapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
- Life Sciences › Immunology and Microbiology › Immunology › Inflammation biomarkers and pathways
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Keywords
- neutrophil-to-lymphocyte ratio, inflammatory markers, cardiovascular disease, acute coronary syndrome, cardiac arrhythmias, mortality prediction, congestive heart failure, aortic valve replacement, valvular heart disease, oxidative stress, GRACE risk score, SYNTAX score
- MeSH terms
- Cardiovascular Diseases, Heart Failure, Humans, Lymphocytes, Neutrophils, Prognosis, Risk, Biomarkers, Disease Progression, Acute Coronary Syndrome
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