High neutrophil-to-lymphocyte ratio linked to poor prognosis in ACS patients with sleep apnea

Announcing a new article publication for Cardiovascular Innovations and Applications journal. This study was aimed at investigating the effects of the neutrophil-to-lymphocyte ratio (NLR) on the long-term prognosis of patients with acute coronary syndrome (ACS) and obstructive sleep apnea (OSA).

This prospective study enrolled patients with ACS and OSA at Anzhen Hospital, Beijing, China between June 2015 and January 2020. OSA was defined by an apnea-hypopnea index ≥15 events·h⁻¹. Baseline NLR was classified as high or low, according to the median. The primary endpoint was major adverse cardiovascular events (MACE), comprising cardiovascular death, recurrent myocardial infarction, stroke, and ischemia-driven revascularization.

A total of 1011 patients with ACS and OSA were enrolled, 506 of whom were in the high NLR (≥2.54) group. No significant differences in sleep monitoring indicators were observed. During a median follow-up of 2.8 (1.4, 3.6) years, a non-linear correlation between NLR and the incident risk of MACE was observed. After adjustment for clinically relevant confounders, a high NLR was independently associated with elevated MACE risk (adjusted HR = 1.45, 95% CI: 1.02-2.06, P = 0.040).

In patients with ACS and OSA, a high NLR was associated with poorer clinical outcomes during long-term follow-up.