Evaluating the impact of neutrophil-to-lymphocyte ratio on disease severity in acute ST-segment elevation myocardial infarction.

Objective: To evaluate the impact of NLR on disease severity and clinical outcomes presenting with acute STEMI. Study Design: Cross-sectional study. Setting: Faisalabad Institute of Cardiology (FIC). Period: March 2024 to August 2024. Methods: A quantitative, cross-sectional study was conducted at the Faisalabad Institute of Cardiology over six months. A total of 385 patients with confirmed STEMI were included through stratified random sampling. Data on demographics, comorbidities, laboratory parameters, and clinical outcomes were collected. The TIMI risk score and the left ventricular ejection fraction (LVEF) were used to assess disease severity. Experiments, statistical analyses include t tests, chi square tests, correlation, and logistic regression were implemented with SPSS. Results: Patients with NLR > 5 demonstrated significantly worse outcomes, including higher TIMI risk scores (5.4 ± 1.5 vs. 3.8 ± 1.2, p < 0.001) and lower LVEF (44.3 ± 5.7% vs. 52.2 ± 5.8%, p < 0.001). Strongly associated with adverse events including cardiogenic shock, recurrent myocardial infarction, and 30 days’ mortality (21.9% vs. 4.4%, p < 0.001), increased NLR levels were. NLR over 5 (OR 3.75, p < 0.001) and LVEF < 45% (OR 4.12, p < 0.001) were identified using the multivariate analysis. Conclusion: The patients with elevated NLR have been shown to be reliable markers of increased disease severity and adverse outcomes in STEMI patients. An addition of NLR to routine clinical assessment would improve risk stratification and could guide management strategies. The integration of NLR with other biomarkers can improve predictive accuracy, and further researches should be performed.