The neutrophil to lymphocyte ratio as a predictor of major adverse cardiovascular events in patients with non-small cell lung cancer

Background : Cancer patients are more susceptible to mortality from cardiovascular disease. This study sought to determine whether the neutrophil to lymphocyte ratio (NLR) could serve as a predictor for major adverse cardiovascular events (MACEs) in patients with non-small cell lung cancer (NSCLC) after surgery. Methods : A retrospective analysis was conducted on clinicopathological data from 204 NSCLC patients who underwent radical surgery at Longyan First Hospital between January 2019 and December 2021. Follow-up for postoperative MACEs was performed until June 2024. The optimal NLR cut-off point was identified using the receiver operating characteristic (ROC) curve. Survival analysis, including Kaplan-Meier and Cox regression methods, was applied to assess the correlation between NLR and patient prognosis. Results : The critical NLR value was determined to be 2.86. Univariate Cox regression analysis indicated that gender, tumor size, NLR, platelet to lymphocyte ratio (PLR), and advanced lung cancer inflammation index (ALI) were associated with MACEs ( P -values: 0.011, <0.001, <0.001, 0.027, 0.001). Furthermore, multivariate Cox regression analysis demonstrated that NLR (HR: 1.104, 95% CI: 1.032-1.182, P = 0.004), tumor diameter (HR: 1.922, 95% CI: 1.160-3.185, P = 0.011), and gender (HR: 1.873, 95% CI: 1.037-3.378, P = 0.037) were independent predictors of MACEs. Conclusions : The elevation of NLR is significantly associated with an increased risk of MACEs in patients with non-small cell lung cancer, making it a valuable tool for risk stratification.