• Osman Turak, Firat Özcan, Ahmet Işleyen, F Nurcan Başar, Murat Gül, Samet Yilmaz, Erdoğan Sökmen, Hüseyin Yüzgeçer, Gökhan Lafçi, Serkan Topaloğlu, and Sinan Aydoğdu.
• Department of Cardiology, Türkiye Yüksek Ihtisas Education and Research Hospital, Ankara, Turkey. Electronic address: osmanturak@yahoo.com.
• Can J Cardiol. 2013 Dec 1;29(12):1672-8.

BackgroundThe neutrophil-to-lymphocyte ratio is an independent predictor of worse prognosis in both infectious and cardiovascular disease. We hypothesized that an increased neutrophil-to-lymphocyte ratio at admission would predict in-hospital unfavourable outcomes in patients with infective endocarditis (IE).MethodsWe retrospectively analyzed clinical, laboratory, and echocardiographic data in a total of 121 consecutive adult patients (64 men; mean age, 54.7 ± 14.2 years) with definite IE.ResultsAmong all patients, the prespecified clinical outcomes were experienced in 46 patients (38%). In-hospital mortality and central nervous system (CNS) events occurred in 29 (24%) and 21 patients (17%), respectively. The neutrophil-to-lymphocyte ratio at admission was found to be significantly higher for either composite end point. On using multiple Cox regression analysis, vegetation size ≥ 10 mm, end-stage renal disease, Staphylococcus aureus infection, low hemoglobin level, increased C-reactive protein (CRP) level, and high neutrophil-to-lymphocyte ratio at admission emerged as independent predictors of in-hospital unfavourable outcomes. In the receiver operating characteristics (ROC) curve analysis, a neutrophil-to-lymphocyte ratio > 7.1 had 80% sensitivity and 83% specificity in predicting adverse outcomes.ConclusionHigh neutrophil-to-lymphocyte ratio at admission is an independent predictor of in-hospital mortality and CNS events in patients with IE. However, prospective validation of these findings is required.Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

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