A US cohort study found that the neutrophil-to-lymphocyte ratio (NLR) was prospectively associated with all-cause mortality and cardiovascular disease (CVD). A Duffy antigen variant locus, a common genetic variant of African origin, was associated with a lower baseline NLR and modified the associations. The study included a population-based longitudinal cohort of 5301 African Americans and validated the findings in an interdisciplinary longitudinal cohort of white men only. Adjusting for potential confounders, elevated NLR (≥2.15) was significantly associated with an increased risk for all-cause mortality (hazard ratio, 1.40) and coronary heart disease (CHD, hazard ratio, 1.69) in the cohort of African Americans. Using a lower NLR cutoff (≥1.77) did not alter the significant associations. In the cohort of white men, elevated NLR was associated with an increased risk of mortality (hazard ratio, 1.32), with no statistical significance. In both prospective studies, NLR was less of a robust predictor when the time of event was more distant. The Duffy antigen variant was associated with neutrophil count, and NLR (≥1.77) was significantly associated with mortality, CHD, stroke, and heart failure in the Duffy antigen–negative group. NLR is known to be associated with mortality and CVD at diagnosis. Source: https://jamanetwork.com/
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