Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Cardiology

Background:Early and accurate risk prediction is an important clinical demand in patients with infective endocarditis (IE). The platelet-to-lymphocyte ratio (PLR) and the neutrophil-to-lymphocyte ratio (NLR) are an independent predictors of worse prognosis in both infectious and cardiovascular disease. Very limited number of studies were conducted to evaluate the prognostic role of these markers in infective endocarditis. The aim of this study was to determine the value of PLR and NLR in the prediction of in-hospital morbidity and mortality among IE patients. Methods:We analyzed clinical, laboratory,echocardiographic data and the clinical course throughout the whole period ofin-hospital stayin a total of 142 consecutive patients with definite IE diagnosis.PLR and NLR were obtained directly from the complete blood count picture taken upon the admission of the patients. Results: The in-hospital mortality, central nervous system, fulminant sepsis, acute heart failure, acute renal failure and embolization to different vital organs complications had occurred in [30 (21%), 38(27%), 34 (24%), 32 (22.5%), 40 (28%) and 90 (63.4%) ] patients respectively. Higher NLR, total leucocytic count, neutrophils percentage, level of creatinine and C-reactive protein(CRP)obtained upon admission were significantly higher in the in-hospital mortality group [p=<0.001, p=0.008, p=0.001, p=0.004 and p=0.036 respectively]; also lower lymphocyte (percentage and count), lower platelet count, presence of multiple valve involvement, presence of severe acute aortic valve regurge and infection by organism like MRSA or candida albican were significantly associated with higher in-hospital mortality rate [ p=(<0.001 and 0.015), p=0.001, p=0.014, p=0.007 and 0.030 or 0.028 respectively. Higher NLR was significantly associated with higher incidence of fulminant sepsis and major arterial embolization in IE patients [p=0.001 and p=0.028 respectively]

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