Dr Nadeem Walayat, Dr Muhammad Azeem Afzal, Dr Nasrullah Ayoubi
Background: Coronary heart disease (CHD) is the leading cause of mortality in the world. ACS is caused by the rupture of the atherosclerotic plaque & inflammation plays a key role. White blood cells (WBCs) are the major mediators of inflammation and WBCs and their differentiation have been studied for prediction of cardiovascular outcomes and early risk assessment. Aim: To determine the in-hospital mortality rate in patients with acute coronary syndrome with elevated neutrophil to lymphocyte ratio (NLR). Study design: A cross-sectional study. Place and Duration: In the Medicine Unit-II of Bahawal Victoria Hospital (BVH) Bahawalpur for one-year duration from May 2019 to May 2020. Method: 550 patients who met the inclusion criteria were enrolled in the study. A history of ischemic heart disease, smoking and diabetes was taken. On admission, a white blood cell count was taken and used to calculate the ratio of neutrophils to lymphocytes. Patients with increased NLR were followed for 7 days with inpatient mortality after admission. The information obtained was recorded on a standardized display. Results: The results showed that in patients with increased NLR on admission, in-hospital mortality increased after 7 days. Diabetes has not been found to have a major influence on the NLR. In addition, patients who suffered from myocardial infarction and smoking patients had a higher NLR compared to other patients. Conclusion: NLR can be used to identify patients at high risk of early mortality after acute coronary syndrome, but its usefulness may be limited by its non-specificity. More research is needed to determine exactly what level of NLR is to be significant. Key words: Acute Coronary Syndrome, Neutrophils, Lymphocytes, Mortality.