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Neutrophil-Lymphocyte Ratio (NLR) as A Predictor for Non-ST Elevation Myocardial Infarction (NSTEMI) in the Emergency Room

Heart Science Journal · Vol. 5 No. 3 (2024) · pp. 39–44

DOI
10.21776/ub/hsj.2024.005.03.7
ISSN
2721-9984, 2721-9976
Published
2024-07-30
Publisher
Universitas Brawijaya
Language
en

Abstract

AbstractBackground: The usefulness of the NLR as an approach to identifying cases of acute coronary syndrome (ACS) needs to be improved.Objective: This research was designed to determine the effectiveness of the NLR in identifying individuals who presented to the emergency room complaining of anginal due to ACS.Methods: The single-center cross-sectional study was performed at Saiful Anwar General Hospital in Malang, East Java, Indonesia, from July 2020 to December 2023. Patients were involved in this study with complaints of angina suspected of ACS. During further observation in the emergency room, based on the findings of the troponin I analysis, individuals were divided into unstable angina pectoris (UAP) and NSTEMI.Results: Study results were collected from 282 individuals diagnosed with Non-ST Elevation Acute Coronary Syndrome (NSTEACS), with 75.9% male and a mean age of 58.39 ± 10.27 years. The NLR threshold was 4.5 (AUC: 0.78, 95% CI: 0.765–0.867, P <.001) assessed during admission, which showed a sensitivity of 79% and a specificity of 78% in accurately predicting the probability of subsequent troponin positivity. Multivariate analysis revealed that the NLR at hospitalization remained an essential marker of troponin positivity during follow-up.Conclusions: In the end, NLR could be considered an initial test in emergency services to predict the diagnosis of NSTEMI in people experiencing angina.Â

Keywords

Collaboration network of the authors

40 authors · 287 co-authorship links · showing the 40 most connected

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  • University of Brawijaya
  • Affiliation unknown
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Co-authorOrganisationJoint articles
Mohammad Saifur RohmanAffiliation unknown69
Ardian RizalAffiliation unknown37
Cholid Tri TjahjonoAffiliation unknown30
Djanggan SargowoAffiliation unknown25
Novi KurnianingsihAffiliation unknown25
Heny MartiniAffiliation unknown23
Sasmojo WiditoAffiliation unknown18
Wella KarolinaAffiliation unknown11
Valerinna YogibuanaAffiliation unknown11
Muhammad Rizki FadlanAffiliation unknown7
Nikhen NoverikeAffiliation unknown6
Imelda KrisnasariAffiliation unknown6
Putri Annisa KamilaUniversity of Brawijaya6
Yoga WaranugrahaAffiliation unknown5
Dea Arie KurniawanAffiliation unknown5
Ayu Asri Devi AdityawatiAffiliation unknown5
Valerinna Yogibuana Swastika PutriAffiliation unknown5
Teguh AryanugrahaAffiliation unknown5
Yuri AfifahAffiliation unknown5
Hayla Iqda MillisaniAffiliation unknown4
Lukitasari Ayu GaluhAffiliation unknown4
Yoseph Budi UtomoAffiliation unknown4
Anita Surya SantosoAffiliation unknown4
Krishna Ari NugrahaAffiliation unknown4
Seprian WidasmaraAffiliation unknown4
Tri AstiawatiAffiliation unknown4
Saskia Dyah HandariAffiliation unknown4
Danti Utami SetyowatiAffiliation unknown3
Muhammad Saifur RohmanAffiliation unknown3
Olivia HandayaniAffiliation unknown3
Fahmy RusnantaAffiliation unknown3
Oktafin Srywati PamunaAffiliation unknown3
Imam Mi'raj SuprayogaAffiliation unknown3
Veny KurniawatiAffiliation unknown2
Cholid Tri TjahjonoAffiliation unknown2

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) https://heartscience.ub.ac.id/index.php/heartscience/oai, first harvested 8 Nov 2026, last seen 8 Nov 2026.
Original metadata (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en">Neutrophil-Lymphocyte Ratio (NLR) as A Predictor for Non-ST Elevation Myocardial Infarction (NSTEMI) in the Emergency Room</dc:title>
	<dc:creator xml:lang="en">Zunardi, Lutfi Hafiz</dc:creator>
	<dc:creator xml:lang="en">Anjarwani, Setyasih</dc:creator>
	<dc:creator xml:lang="en">Prasetya, Indra</dc:creator>
	<dc:creator xml:lang="en">Satrijo, Budi</dc:creator>
	<dc:creator xml:lang="en">Rahimah, Anna Fuji</dc:creator>
	<dc:subject xml:lang="en">Marker Inflammation</dc:subject>
	<dc:subject xml:lang="en">NLR</dc:subject>
	<dc:subject xml:lang="en">NSTEMI</dc:subject>
	<dc:subject xml:lang="en">Troponin I.</dc:subject>
	<dc:description xml:lang="en">AbstractBackground: The usefulness of the NLR as an approach to identifying cases of acute coronary syndrome (ACS) needs to be improved.Objective: This research was designed to determine the effectiveness of the NLR in identifying individuals who presented to the emergency room complaining of anginal due to ACS.Methods: The single-center cross-sectional study was performed at Saiful Anwar General Hospital in Malang, East Java, Indonesia, from July 2020 to December 2023. Patients were involved in this study with complaints of angina suspected of ACS. During further observation in the emergency room, based on the findings of the troponin I analysis, individuals were divided into unstable angina pectoris (UAP) and NSTEMI.Results: Study results were collected from 282 individuals diagnosed with Non-ST Elevation Acute Coronary Syndrome (NSTEACS), with 75.9% male and a mean age of 58.39 ± 10.27 years. The NLR threshold was 4.5 (AUC: 0.78, 95% CI: 0.765–0.867, P &amp;lt;.001) assessed during admission, which showed a sensitivity of 79% and a specificity of 78% in accurately predicting the probability of subsequent troponin positivity. Multivariate analysis revealed that the NLR at hospitalization remained an essential marker of troponin positivity during follow-up.Conclusions: In the end, NLR could be considered an initial test in emergency services to predict the diagnosis of NSTEMI in people experiencing angina. </dc:description>
	<dc:publisher xml:lang="en">Universitas Brawijaya</dc:publisher>
	<dc:date>2024-07-30</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://heartscience.ub.ac.id/index.php/heartscience/article/view/15759</dc:identifier>
	<dc:identifier>10.21776/ub/hsj.2024.005.03.7</dc:identifier>
	<dc:source xml:lang="en">Heart Science Journal; Vol. 5 No. 3 (2024): The Science and Art of Revascularization in Acute Coronary Syndrome; 39-44</dc:source>
	<dc:source>2721-9984</dc:source>
	<dc:source>2721-9976</dc:source>
	<dc:source>10.21776/ub.hsj.2024.005.03</dc:source>
	<dc:language>en</dc:language>
	<dc:relation>https://heartscience.ub.ac.id/index.php/heartscience/article/view/15759/423</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2024 Lutfi hafiz zunardi</dc:rights>
</oai_dc:dc>