Objective.This systematic reviewaimed to measure the association between neutrophil lymphocyte ratio (NLR) and cardiovascular\ndisease (CVD) risk. Methods. Relevant studies were identified from Medline and Scopus databases. Observational studies with\nNLR as a study factor were eligible for review.The outcomes of interest were any type of CVD including acute coronary syndrome,\ncoronary artery disease, stroke, or a composite of these cardiovascular events. Mean differences in NLR between CVD and non-\nCVDpatients were pooled using unstandardized mean difference (USMD). Odds ratios of CVDbetween high and low NLR groups\nwere pooled using a random effects model. Results. Thirty-eight studies (n=76,002) were included. High NLR was significantly\nassociated with the risks of CAD, ACS, stroke, and composite cardiovascular events with pooled ORs of 1.62 (95% CI: 1.38-1.91),\n1.64 (95% CI: 1.30, 2.05), 2.36 (95% CI: 1.44, 2.89), and 3.86 (95% CI: 1.73, 8.64), respectively. In addition, mean NLRs inCAD,ACS,\nand stroke patients were significantly higher than in control groups. Conclusion. High NLR was associated with CAD, ACS, stroke,\nand composite cardiovascular events.Therefore, NLR may be a useful CVD biomarker.
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