Evidence map›Paper›PMID 29074043›Full record

Trial reportInternational journal of cardiology2018

Change in lymphocyte to neutrophil ratio predicts acute rejection after heart transplantation.

Dong-Hyun Choi, Yuhei Kobayashi, Takeshi Nishi, Helen Luikart, Sadia Dimbil, Jon Kobashigawa, Kiran Khush, William F Fearon

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in International journal of cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
3.0field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 25 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
  7. Article
  8. Observational
  9. Review
  10. Observational
  11. Article
  12. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Dong-Hyun ChoiDivision of Cardiovascular Medicine, Stanford University, Stanford, CA, USA; Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Republic of Korea.
Yuhei KobayashiDivision of Cardiovascular Medicine, Stanford University, Stanford, CA, USA.
Takeshi NishiDivision of Cardiovascular Medicine, Stanford University, Stanford, CA, USA.
Helen LuikartDivision of Cardiovascular Medicine, Stanford University, Stanford, CA, USA.
Sadia DimbilHeart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Jon KobashigawaHeart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Kiran KhushDivision of Cardiovascular Medicine, Stanford University, Stanford, CA, USA.
William F FearonDivision of Cardiovascular Medicine, Stanford University, Stanford, CA, USA. Electronic address: wfearon@stanford.edu.
Stanford University · USCedars-Sinai Medical Center · USChosun University · KRStanford Medicine · US

Funding

ACE Inhibition and Cardiac Allograft VasculopathyR01HL093475 · NHLBI · STANFORD UNIVERSITY · PI FEARON, WILLIAM F · 2009 to 2013
$1.7M
NHLBI NIH HHS R01 HL093475
6 · The paper itself

Abstract

aimsMost immunosuppressive drugs provide targeted immunosuppression by selective inhibition of lymphocyte activation and proliferation. This study evaluated whether a change in the lymphocyte to neutrophil ratio (LNR) is related to acute rejection.

methodsIn 74 cardiac transplant recipients peripheral blood lymphocyte and neutrophil counts were measured soon after (baseline) and three, six, and 12months after heart transplantation. The primary endpoint was the incidence of acute rejection.

resultsSignificant acute rejection after heart transplantation occurred in 20 patients (27%) during a median follow-up of 49.4 [IQR 37.4-61.1] months. LNR significantly increased over time (0.1149±0.1354 at baseline, 0.2330±0.2266 at 3months, 0.2961±0.2849 at 6months, and 0.3521±0.2383 at 12months; P<0.001), especially during the first 3months in the group without acute rejection. The area under the curve of the change in LNR during the first three months (ΔLNR) for acute rejection was 0.565 (95% CI 0.420 to 0.710, P=0.380) on ROC curve analysis. The best cutoff value of Δ LNR to differentiate those with and without acute rejection was ≤0.046 by ROC curve analysis. Kaplan-Meier analysis revealed that the low ΔLNR group (≤0.046) had a significantly higher rate of acute rejection than the high ΔLNR group (>0.046) (37.5% vs. 19.0%, log-rank: P=0.0358). The low ΔLNR for the first 3months was an independent predictor of clinically significant acute rejection after adjusting for cytomegalovirus donor seropositive and recipient seronegative.

conclusionsThe results of this study suggest that ΔLNR over the first 3months after heart transplantation is a strong and independent predictor of acute rejection after heart transplantation. ΔLNR can be used as an early biomarker for predicting of acute rejection after heart transplantation.

Indexed as

AdultAgedDouble-Blind MethodFemaleFollow-Up StudiesGraft RejectionHeart TransplantationHumansLymphocytesMaleMiddle AgedNeutrophilsPredictive Value of TestsProspective StudiesRetrospective StudiesAcute rejectionHeart transplantationLymphocyte neutrophil ratio

Identifiers

PMID29074043
PMCPMC6331210
OpenAlexW2767108866

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.