The Role of Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) as Predictors of Reduced Left Ventricular Ejection Fraction (LVEF) in Heart Failure Patients

  • Muhammad Ainul Yaqin
  • Putu Ristyaning Ayu Sangging 2Department of Clicinal Pathology, Faculty of Medicine, Universitas Lampung, Bandar Lampung, Indonesia
  • Suryani Agustina Daulay Faculty of Medicine, Universitas Lampung, Bandar Lampung, Indonesia
  • Iswandi Darwis Faculty of Medicine, Universitas Lampung, Bandar Lampung, Indonesia
DOI: https://doi.org/10.22146/jaci.v11i1.18722

Abstract

Background: Heart failure can be called as an emerging epidemic due to increasing cases along with the increasing population. The pathogenesis of heart failure is closely related to inflammation. Some of the biomarkers that can be used to assess the severity of inflammation in patients is neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR).

Objectives: The purpose of this study was to determine the relationship between NLR and PLR with left ventricular ejection fraction (LVEF) and to determine the role of NLR and PLR as predictors of reduced LVEF.

Methods: This study is an observational analytical study with a cross-sectional design in heart failure patients at Dr. H. Abdul Moeloek Hospital, Lampung Province throughout 2023. In total, 88 heart failure patients were included in this study. This study used the Spearman Rank correlation test and receiver operating characteristics (ROC) analysis test to find the cut-off point of NLR and PLR as predictors of reduced left ventricular ejection fraction. In this study, left ventricular ejection fraction was divided into 2 groups (≤40% and >40%).

Result: NLR has a significant relationship with LVEF (r: -0.290, p value: 0.006) and PLR also has a significant relationship with LVEF (r: -0.297, p value: 0.005). NLR> 2.67 can be used as a predictor of reduced left ventricular ejection fraction with a sensitivity of 70.7% and a specificity of 70% (AUC: 0.747, p value: <0.001). PLR> 119.69 can be used as a predictor of reduced left ventricular ejection fraction with a sensitivity of 62.1% and a specificity of 63.3% (AUC: 707, p value: 0.001).

Conclusion: NLR and PLR are associated with LVEF in patients with heart failure. NLR >2.67 and PLR >119.69 can be used as a cheap, simple, and fast predictor in predicting reduced LVEF in heart failure patients.

 

Keywords: neutrophil lymphocyte ratio; platelet lymphocyte ratio; left ventricular ejection fraction; heart failure

Published
2025-12-10
Issue
Vol 11 No 1 (2025): Acta Cardiologia Indoneisana
Section
Research Articles