High neutrophil to lymphocyte ratio in type A acute aortic dissection facilitates diagnosis and predicts worse outcome

Expert Rev Mol Diagn. 2015;15(7):965-70. doi: 10.1586/14737159.2015.1042367. Epub 2015 May 17.

Abstract

Objective: The authors investigated whether neutrophil to lymphocyte ratio (N/L) can contribute to the diagnosis and risk assessment in patients with type A acute aortic dissection (AAD).

Methods: The authors studied 120 consecutive patients with type A AAD (group I) and compared them with 121 consecutive patients with chronic aneurysms (group II) and 121 age- and sex-matched healthy subjects (group III).

Result: It was found that white blood cell count, N/L, D-dimer and C-reactive protein were significantly higher in group I versus both groups II and III (p < 0.001 for all comparisons). White blood cell count and D-dimer were much higher in patients who died compared to survivors in group I (p = 0.023 and p = 0.033, respectively). A cutoff value of N/L >4.6 was associated with 0.89 sensitivity and 0.91 specificity for AAD.

Conclusion: High N/L may contribute to the diagnostic evaluation and prompt immediate therapy in patients with type A AAD.

Keywords: acute aortic dissection; biomarkers; chronic aneurysms; neutrophil to lymphocyte ratio.

MeSH terms

  • Acute Disease
  • Aged
  • Aortic Aneurysm / blood*
  • Aortic Aneurysm / diagnosis*
  • Aortic Aneurysm / etiology
  • Aortic Aneurysm / mortality
  • Aortic Dissection / blood*
  • Aortic Dissection / diagnosis*
  • Aortic Dissection / etiology
  • Aortic Dissection / mortality
  • Biomarkers
  • C-Reactive Protein
  • Female
  • Fibrin Fibrinogen Degradation Products
  • Humans
  • Leukocyte Count*
  • Lymphocytes / pathology*
  • Male
  • Middle Aged
  • Neutrophils / pathology*
  • Patient Outcome Assessment
  • Prognosis
  • ROC Curve
  • Risk Factors

Substances

  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D
  • C-Reactive Protein