Behaviour of the neutrophil to lymphocyte ratio in young subjects with acute myocardial infarction

In the last years the neutrophil to lymphocyte ratio (NLR) has been examined in cardiovascular disorders and in particular in coronary artery disease and acute myocardial infarction (AMI). Now we examined this parameter in subjects with juvenile myocardial infarction at the initial stage and after 3 and 12 months. We enrolled 123 young subjects (112 men and 11 women, mean age 39.4±5.8 yrs) with AMI. The time interval between the AMI onset and the investigation was 13±7 days. The mean value of NLR observed in young AMI subjects was significantly increased compared to normal controls (N = 1.817±0.711; young AMI subjects = 2.376±0.873, p < 0.0001). NLR does not discriminate STEMI (2.427±0.878) and non STEMI (2.392±0.868) or diabetics (2.604±1.000) and non diabetics (2.324±0.853), but it differentiates smokers (2.276±0.853) and non smokers (2.837±1.072). NLR at the initial stage is not correlated with the number of cardiovascular risk factors or with the extent of the coronary disease. In this study we found a significant decrease of neutrophil count at 3 and 12 months later AMI without any significant variation of lymphocyte and consequently we observed a decrease in NLR at these two intervals of time in comparison with the initial stage. Despite some limitations present in this study, it is interesting to underline that also in juvenile myocardial infarction this low-cost haematological marker may be considered together with other inflammatory indicators.