Response to: Balta S, Kurtoglu E, Kucuk U, Demirkol S, Ozturk C. Neutrophil–lymphocyte ratio as an important assessment tool. Expert. Rev. Cardiovasc. Ther. 12(5), 537–538 (2014).
We thank Balta and colleagues for providing us with a very comprehensive analysis of our publication Citation[1,2]. Neutrophil–lymphocyte ratio (NLR), which is calculated from complete blood count with differential, is an inexpensive, easy to obtain, widely available marker of inflammation that can aid in the risk stratification of patients with various cardiovascular diseases in addition to the traditionally used markers.
In their study, Balta and colleagues have also highlighted NLR's association with the presence of left atrial thrombus in patients with non-valvular atrial fibrillation Citation[3], which has been very enlightening to us as researchers. NLR has also been associated with arterial stiffness and high coronary calcium score, which are significant markers of cardiovascular disease. It is also reported as an independent predictor of outcome in stable coronary artery disease, as well as a predictor of short- and long-term mortality in patients with acute coronary syndromes. Furthermore, it is linked with increased risk of ventricular arrhythmias during percutaneous coronary intervention (PCI) and higher long-term mortality in patients undergoing PCI irrespective of indications of PCI.
In patients admitted with advanced heart failure, high NLR is reported with higher inpatient mortality. Recently, NLR has also been reported as a prognostic marker for outcome from coronary artery bypass grafting and post-coronary artery bypass grafting atrial fibrillation.
We are continuing our efforts to explore the association between NLR and other disease markers in mechanisms of various diseases and are hopeful that our future contributions will be of even greater utility in the field of research.
Financial & competing interests disclosure
The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.
No writing assistance was utilized in the production of this manuscript.
References
- Akhtar MS, Bhat T, Teli S, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert Rev Cardiovasc Ther 2013;11(1):55-9
- Balta S, Kurtoglu E, Kucuk U, et al. Neutrophil–lymphocyte ratio as an important assessment tool. Expert Rev Cardiovasc Ther 2014;12(5):537-8
- Yalcin M, Aparci M, Uz O, et al. Neutrophil-lymphocyte ratio may predict left atrial thrombus in patients with nonvalvular atrial fibrillation. Clin Appl Thromb Hemost 2013. [Epub ahead of print]