NLR AND CRP Useful as Cost-Effective Preliminary Prognostic Markers in ST-Elevation Myocardial Infarction

Acute myocardial infarction (AMI) is a serious and fatal cardiovascular emergency and considered the leading cause of mortality worldwide.

• Atherosclerosis of coronary arteries which takes decades to manifest clinically, is the primary predisposing pathologic factor responsible for the development of coronary heart disease
• It has been shown that A complex immune and inflammatory pathophysiological process is thought to be crucial for in the initiation and progression of atherosclerotic plaques
• Inflammation is one of the main mechanisms in the pathogenesis of atherosclerosis , Destabilization of chronic artery plaques and development of thrombosis, which are the main mechanisms in the pathophysiology of ST-segment elevation myocardial infarction (STEMI) .

, and the interest to the evaluation of inflammatory biomarkers in coronary artery disease (CAD) has been increasing over the last decade .

• Although numerous inflammatory markers, including troponin T/I, lactate dehydrogenase (LDH), and creatine kinase (CK-MB), are linked to worsened clinical outcomes in both ST elevation and non-ST elevation myocardial infarction (NSTEMI), there is an unmet need for a cost-effective biomarker for impoverished countries of the world
• The neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP) ;
• has emerged as an important inflammatory markers for cardiovascular risk stratification.
• And are relatively cheap inflammatory markers, can act as a bridge to mitigate the gap in assessing the cardiovascular risk and outcomes In patients with acute myocardial infarction.
• Recent data indicates a strong independent relationship between increased complications after acute myocardial infarction in patients with a high NLR and high CRP level at admission and the initial post-hospitalization period.
• Accordingly, we designed this study to assess the predictive value and prognosis of NLR and CRP in ST-elevation myocardial infarction (STEMI).

Inclusion criteria

• Patients with age ≥18 years of either sex, with either increase in serum cardiac biomarkers or ECG are STEMI.

Exclusion criteria

• Patients presenting with NSTEMI and unstable angina
• Patients with any of these associated conditions that can affect NLR or CRP including
• Inflammatory conditions such as collagen-vascular disorders
• Acute or chronic infectious diseases.
• Auto-immune and neoplastic diseases.
• Chronic hepatic diseases.
• Renal failure.
• Thyroid disorders.
• Previous valvular heart disease.