PT  - JOURNAL ARTICLE
AU  - Vasile Foris
AU  - Gabor Kovacs
AU  - Philipp Douschan
AU  - Alexander Avian
AU  - Andrea Olschewski
AU  - Horst Olschewski
TI  - Neutrophil- to-lymphocyte ratio as a prognostic parameter in pulmonary arterial hypertension
AID  - 10.1183/13993003.congress-2016.PA2479
DP  - 2016 Sep 01
TA  - European Respiratory Journal
PG  - PA2479
VI  - 48
IP  - suppl 60
4099  - http://erj.ersjournals.com/content/48/suppl_60/PA2479.short
4100  - http://erj.ersjournals.com/content/48/suppl_60/PA2479.full
SO  - Eur Respir J2016 Sep 01; 48
AB  - Introduction: Differential blood count is routinely done at the time of diagnostic work-up and during follow-up of pulmonary arterial hypertension (PAH), however, the prognostic value of the specific cell counts is unknown.Aims and objectives: We aimed to analyze white cell differential counts in PAH patients and their prognostic relevance.Patients and methods: In this retrospective study we included n= 83 newly diagnosed (incident) PAH patients and n=71 patients where pulmonary hypertension was excluded by means of right heart catheterization. White blood cell differential counts were compared between groups using Mann Whitney U test. Area under the curve was calculated for each cell type as well as for neutrophil-to-lymphocyte ratio (NLR). Survival analysis was performed based on the best cut-off values. Data are presented as mean ± standard deviation.Results: The relative and absolute number of lymphocytes was decreased in PAH as compared to controls (22.3 ± 10 % vs. 25.4 ± 8.8 % , p<0.006, 1.5 ± 0.7 G/µl vs. 1.6 ± 0.6 G/µl, p<0.025). There was a slight but significant increase in the relative neutrophil count in PAH as compared to control (66.8 ± 11.5% vs. 64.4 ± 10.7%, p<0.037) but there were no differences in monocyte or eosinophil counts. NLR was slightly but significantly increased in PAH as compared to control (3.8 ± 2.5 vs. 3.3 ± 2.7 p<0.008). NLR ≥2.62 identified PAH patients with a 69% sensitivity and 56% specificity and was associated with a poor overall 5 year survival in PAH patients (47% vs. 69%, p<0.038).Conclusion: Neutrophil- to- lymphocyte ratio is a simple tool which may be of prognostic relevance in PAH patients.