Neutrophil-to-lymphocyte ratio as a prognostic biomarker in patients with peripheral artery disease: A systematic review and meta-analysis
Background: The neutrophil-to-lymphocyte ratio (NLR) is a simple and routinely obtained parameter reflecting systemic inflammation, including in peripheral artery disease (PAD). Methods: This systematic review aimed to assess the role of NLR as a prognostic biomarker in patients with PAD. A systemat...
Gespeichert in:
| Veröffentlicht in: | Vascular medicine (London, England) England), 2024-12, Vol.29 (6), p.687-699 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 699 |
|---|---|
| container_issue | 6 |
| container_start_page | 687 |
| container_title | Vascular medicine (London, England) |
| container_volume | 29 |
| creator | Kurniawan, Roy B Siahaan, Paulus P Saputra, Pandit BT Arnindita, Jannatin N Savitri, Cornelia G Faizah, Novia N Andira, Luqman H D’Oria, Mario Eko Putranto, J Nugroho Alkaff, Firas F |
| description | Background:
The neutrophil-to-lymphocyte ratio (NLR) is a simple and routinely obtained parameter reflecting systemic inflammation, including in peripheral artery disease (PAD).
Methods:
This systematic review aimed to assess the role of NLR as a prognostic biomarker in patients with PAD. A systematic search was conducted across PubMed, ScienceDirect, Web of Science, Scopus, ProQuest, EBSCO, and Cochrane. Random-effects meta-analysis was used to pool risk ratios, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). A bivariate model was used to generate summary receiver operating characteristics with the corresponding area under the curve (AUC).
Results:
This review included 5243 patients with PAD from nine eligible studies. High NLR corresponded to at least a twofold increased risk of all-cause mortality (ACM), major adverse limb events (MALE), and major adverse cardiovascular events (MACE). NLR’s performance was good for predicting 1-year ACM (AUC 0.71 [95% CI: 0.59–0.79], sensitivity 58.2% [95% CI: 45.3–71.0], specificity 72.6% [95% CI: 65.6–79.62], PPV 41.0% [95% CI: 31.2–50.7], NPV 82.7% [95% CI: 74.1–91.3]) and 1-year MALE (AUC 0.78 [95% CI: 0.75–0.80], sensitivity 65.4% [95% CI: 41.6–89.2], specificity 77.7% [95% CI: 71.0–84.3], PPV 53.7% [95% CI: 47.3–60.1], NPV 83.91% [95% CI: 73.2–94.6]). However, these values tended to decrease as the follow-up duration extended, except for the pooled specificities, which exhibited the opposite pattern.
Conclusion:
NLR emerges as a simple and cost-effective prognostic biomarker with decent performance for poor outcomes in patients with PAD (PROSPERO Registration No.: CRD42023486607). |
| doi_str_mv | 10.1177/1358863X241281699 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11590382</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_1358863X241281699</sage_id><sourcerecordid>3117617290</sourcerecordid><originalsourceid>FETCH-LOGICAL-c306t-6e8c7528a3d48f20076f137b5088de3e86f00848d2b7ac7e31d0c9e887b48c2e3</originalsourceid><addsrcrecordid>eNp1kc1u1TAQhS0EouXCA7BBlth0k-KfJLbZoKqCFqmCDUjsLMeZ3LgkcbCdVnkFnhpHt5Q_sZqR5pszc3QQek7JKaVCvKK8krLmX1hJmaS1Ug_QMS2FKAgX4mHu87zYgCP0JMZrQoioFX2MjrgqaVURdoy-f4AlBT_3biiSL4Z1nHtv1wQ4mOQ8NhEbPAe_n3xMzuLG-dGErxCwm_CcEZhSxLcu9XiG4OYeghmwCQnCilsXwUR4jc9wXGOC0WwSAW4c3GIztXiEZAozmWGNLj5FjzozRHh2V3fo87u3n84vi6uPF-_Pz64Ky0mdihqkFRWThrel7NjmqaNcNBWRsgUOsu4IkaVsWSOMFcBpS6wCKUVTSsuA79Cbg-68NCO0NjvIP-s5uOxs1d44_edkcr3e-xtNaaUIlywrnNwpBP9tgZj06KKFYTAT-CVqntOpqWCZ3qGXf6HXfgnZ8UZxpihRQmWKHigbfIwBuvtvKNFb1PqfqPPOi99t3G_8zDYDpwcgmj38Ovt_xR9qLLTc</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3132910979</pqid></control><display><type>article</type><title>Neutrophil-to-lymphocyte ratio as a prognostic biomarker in patients with peripheral artery disease: A systematic review and meta-analysis</title><source>Access via SAGE</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Kurniawan, Roy B ; Siahaan, Paulus P ; Saputra, Pandit BT ; Arnindita, Jannatin N ; Savitri, Cornelia G ; Faizah, Novia N ; Andira, Luqman H ; D’Oria, Mario ; Eko Putranto, J Nugroho ; Alkaff, Firas F</creator><creatorcontrib>Kurniawan, Roy B ; Siahaan, Paulus P ; Saputra, Pandit BT ; Arnindita, Jannatin N ; Savitri, Cornelia G ; Faizah, Novia N ; Andira, Luqman H ; D’Oria, Mario ; Eko Putranto, J Nugroho ; Alkaff, Firas F</creatorcontrib><description>Background:
The neutrophil-to-lymphocyte ratio (NLR) is a simple and routinely obtained parameter reflecting systemic inflammation, including in peripheral artery disease (PAD).
Methods:
This systematic review aimed to assess the role of NLR as a prognostic biomarker in patients with PAD. A systematic search was conducted across PubMed, ScienceDirect, Web of Science, Scopus, ProQuest, EBSCO, and Cochrane. Random-effects meta-analysis was used to pool risk ratios, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). A bivariate model was used to generate summary receiver operating characteristics with the corresponding area under the curve (AUC).
Results:
This review included 5243 patients with PAD from nine eligible studies. High NLR corresponded to at least a twofold increased risk of all-cause mortality (ACM), major adverse limb events (MALE), and major adverse cardiovascular events (MACE). NLR’s performance was good for predicting 1-year ACM (AUC 0.71 [95% CI: 0.59–0.79], sensitivity 58.2% [95% CI: 45.3–71.0], specificity 72.6% [95% CI: 65.6–79.62], PPV 41.0% [95% CI: 31.2–50.7], NPV 82.7% [95% CI: 74.1–91.3]) and 1-year MALE (AUC 0.78 [95% CI: 0.75–0.80], sensitivity 65.4% [95% CI: 41.6–89.2], specificity 77.7% [95% CI: 71.0–84.3], PPV 53.7% [95% CI: 47.3–60.1], NPV 83.91% [95% CI: 73.2–94.6]). However, these values tended to decrease as the follow-up duration extended, except for the pooled specificities, which exhibited the opposite pattern.
Conclusion:
NLR emerges as a simple and cost-effective prognostic biomarker with decent performance for poor outcomes in patients with PAD (PROSPERO Registration No.: CRD42023486607).</description><identifier>ISSN: 1358-863X</identifier><identifier>ISSN: 1477-0377</identifier><identifier>EISSN: 1477-0377</identifier><identifier>DOI: 10.1177/1358863X241281699</identifier><identifier>PMID: 39415502</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Aged ; Biomarkers ; Biomarkers - blood ; Bivariate analysis ; Female ; Humans ; Leukocytes (neutrophilic) ; Lymphocyte Count ; Lymphocytes ; Lymphocytes - cytology ; Male ; Males ; Meta-analysis ; Middle Aged ; Neutrophils ; Neutrophils - cytology ; Original s ; Peripheral Arterial Disease - blood ; Peripheral Arterial Disease - diagnosis ; Peripheral Arterial Disease - immunology ; Peripheral Arterial Disease - mortality ; Predictive Value of Tests ; Prognosis ; Risk Assessment ; Risk Factors ; Sensitivity analysis ; Systematic review ; Vascular diseases ; Vein & artery diseases</subject><ispartof>Vascular medicine (London, England), 2024-12, Vol.29 (6), p.687-699</ispartof><rights>The Author(s) 2024</rights><rights>The Author(s) 2024 2024 SAGE Publications</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c306t-6e8c7528a3d48f20076f137b5088de3e86f00848d2b7ac7e31d0c9e887b48c2e3</cites><orcidid>0000-0002-7156-7827 ; 0000-0002-5628-1345 ; 0000-0002-3501-1872</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1358863X241281699$$EPDF$$P50$$Gsage$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1358863X241281699$$EHTML$$P50$$Gsage$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39415502$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kurniawan, Roy B</creatorcontrib><creatorcontrib>Siahaan, Paulus P</creatorcontrib><creatorcontrib>Saputra, Pandit BT</creatorcontrib><creatorcontrib>Arnindita, Jannatin N</creatorcontrib><creatorcontrib>Savitri, Cornelia G</creatorcontrib><creatorcontrib>Faizah, Novia N</creatorcontrib><creatorcontrib>Andira, Luqman H</creatorcontrib><creatorcontrib>D’Oria, Mario</creatorcontrib><creatorcontrib>Eko Putranto, J Nugroho</creatorcontrib><creatorcontrib>Alkaff, Firas F</creatorcontrib><title>Neutrophil-to-lymphocyte ratio as a prognostic biomarker in patients with peripheral artery disease: A systematic review and meta-analysis</title><title>Vascular medicine (London, England)</title><addtitle>Vasc Med</addtitle><description>Background:
The neutrophil-to-lymphocyte ratio (NLR) is a simple and routinely obtained parameter reflecting systemic inflammation, including in peripheral artery disease (PAD).
Methods:
This systematic review aimed to assess the role of NLR as a prognostic biomarker in patients with PAD. A systematic search was conducted across PubMed, ScienceDirect, Web of Science, Scopus, ProQuest, EBSCO, and Cochrane. Random-effects meta-analysis was used to pool risk ratios, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). A bivariate model was used to generate summary receiver operating characteristics with the corresponding area under the curve (AUC).
Results:
This review included 5243 patients with PAD from nine eligible studies. High NLR corresponded to at least a twofold increased risk of all-cause mortality (ACM), major adverse limb events (MALE), and major adverse cardiovascular events (MACE). NLR’s performance was good for predicting 1-year ACM (AUC 0.71 [95% CI: 0.59–0.79], sensitivity 58.2% [95% CI: 45.3–71.0], specificity 72.6% [95% CI: 65.6–79.62], PPV 41.0% [95% CI: 31.2–50.7], NPV 82.7% [95% CI: 74.1–91.3]) and 1-year MALE (AUC 0.78 [95% CI: 0.75–0.80], sensitivity 65.4% [95% CI: 41.6–89.2], specificity 77.7% [95% CI: 71.0–84.3], PPV 53.7% [95% CI: 47.3–60.1], NPV 83.91% [95% CI: 73.2–94.6]). However, these values tended to decrease as the follow-up duration extended, except for the pooled specificities, which exhibited the opposite pattern.
Conclusion:
NLR emerges as a simple and cost-effective prognostic biomarker with decent performance for poor outcomes in patients with PAD (PROSPERO Registration No.: CRD42023486607).</description><subject>Aged</subject><subject>Biomarkers</subject><subject>Biomarkers - blood</subject><subject>Bivariate analysis</subject><subject>Female</subject><subject>Humans</subject><subject>Leukocytes (neutrophilic)</subject><subject>Lymphocyte Count</subject><subject>Lymphocytes</subject><subject>Lymphocytes - cytology</subject><subject>Male</subject><subject>Males</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>Neutrophils</subject><subject>Neutrophils - cytology</subject><subject>Original s</subject><subject>Peripheral Arterial Disease - blood</subject><subject>Peripheral Arterial Disease - diagnosis</subject><subject>Peripheral Arterial Disease - immunology</subject><subject>Peripheral Arterial Disease - mortality</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Sensitivity analysis</subject><subject>Systematic review</subject><subject>Vascular diseases</subject><subject>Vein & artery diseases</subject><issn>1358-863X</issn><issn>1477-0377</issn><issn>1477-0377</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><sourceid>EIF</sourceid><recordid>eNp1kc1u1TAQhS0EouXCA7BBlth0k-KfJLbZoKqCFqmCDUjsLMeZ3LgkcbCdVnkFnhpHt5Q_sZqR5pszc3QQek7JKaVCvKK8krLmX1hJmaS1Ug_QMS2FKAgX4mHu87zYgCP0JMZrQoioFX2MjrgqaVURdoy-f4AlBT_3biiSL4Z1nHtv1wQ4mOQ8NhEbPAe_n3xMzuLG-dGErxCwm_CcEZhSxLcu9XiG4OYeghmwCQnCilsXwUR4jc9wXGOC0WwSAW4c3GIztXiEZAozmWGNLj5FjzozRHh2V3fo87u3n84vi6uPF-_Pz64Ky0mdihqkFRWThrel7NjmqaNcNBWRsgUOsu4IkaVsWSOMFcBpS6wCKUVTSsuA79Cbg-68NCO0NjvIP-s5uOxs1d44_edkcr3e-xtNaaUIlywrnNwpBP9tgZj06KKFYTAT-CVqntOpqWCZ3qGXf6HXfgnZ8UZxpihRQmWKHigbfIwBuvtvKNFb1PqfqPPOi99t3G_8zDYDpwcgmj38Ovt_xR9qLLTc</recordid><startdate>20241201</startdate><enddate>20241201</enddate><creator>Kurniawan, Roy B</creator><creator>Siahaan, Paulus P</creator><creator>Saputra, Pandit BT</creator><creator>Arnindita, Jannatin N</creator><creator>Savitri, Cornelia G</creator><creator>Faizah, Novia N</creator><creator>Andira, Luqman H</creator><creator>D’Oria, Mario</creator><creator>Eko Putranto, J Nugroho</creator><creator>Alkaff, Firas F</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>AFRWT</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7156-7827</orcidid><orcidid>https://orcid.org/0000-0002-5628-1345</orcidid><orcidid>https://orcid.org/0000-0002-3501-1872</orcidid></search><sort><creationdate>20241201</creationdate><title>Neutrophil-to-lymphocyte ratio as a prognostic biomarker in patients with peripheral artery disease: A systematic review and meta-analysis</title><author>Kurniawan, Roy B ; Siahaan, Paulus P ; Saputra, Pandit BT ; Arnindita, Jannatin N ; Savitri, Cornelia G ; Faizah, Novia N ; Andira, Luqman H ; D’Oria, Mario ; Eko Putranto, J Nugroho ; Alkaff, Firas F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c306t-6e8c7528a3d48f20076f137b5088de3e86f00848d2b7ac7e31d0c9e887b48c2e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Biomarkers</topic><topic>Biomarkers - blood</topic><topic>Bivariate analysis</topic><topic>Female</topic><topic>Humans</topic><topic>Leukocytes (neutrophilic)</topic><topic>Lymphocyte Count</topic><topic>Lymphocytes</topic><topic>Lymphocytes - cytology</topic><topic>Male</topic><topic>Males</topic><topic>Meta-analysis</topic><topic>Middle Aged</topic><topic>Neutrophils</topic><topic>Neutrophils - cytology</topic><topic>Original s</topic><topic>Peripheral Arterial Disease - blood</topic><topic>Peripheral Arterial Disease - diagnosis</topic><topic>Peripheral Arterial Disease - immunology</topic><topic>Peripheral Arterial Disease - mortality</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Sensitivity analysis</topic><topic>Systematic review</topic><topic>Vascular diseases</topic><topic>Vein & artery diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kurniawan, Roy B</creatorcontrib><creatorcontrib>Siahaan, Paulus P</creatorcontrib><creatorcontrib>Saputra, Pandit BT</creatorcontrib><creatorcontrib>Arnindita, Jannatin N</creatorcontrib><creatorcontrib>Savitri, Cornelia G</creatorcontrib><creatorcontrib>Faizah, Novia N</creatorcontrib><creatorcontrib>Andira, Luqman H</creatorcontrib><creatorcontrib>D’Oria, Mario</creatorcontrib><creatorcontrib>Eko Putranto, J Nugroho</creatorcontrib><creatorcontrib>Alkaff, Firas F</creatorcontrib><collection>Sage Journals GOLD Open Access 2024</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Vascular medicine (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kurniawan, Roy B</au><au>Siahaan, Paulus P</au><au>Saputra, Pandit BT</au><au>Arnindita, Jannatin N</au><au>Savitri, Cornelia G</au><au>Faizah, Novia N</au><au>Andira, Luqman H</au><au>D’Oria, Mario</au><au>Eko Putranto, J Nugroho</au><au>Alkaff, Firas F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neutrophil-to-lymphocyte ratio as a prognostic biomarker in patients with peripheral artery disease: A systematic review and meta-analysis</atitle><jtitle>Vascular medicine (London, England)</jtitle><addtitle>Vasc Med</addtitle><date>2024-12-01</date><risdate>2024</risdate><volume>29</volume><issue>6</issue><spage>687</spage><epage>699</epage><pages>687-699</pages><issn>1358-863X</issn><issn>1477-0377</issn><eissn>1477-0377</eissn><abstract>Background:
The neutrophil-to-lymphocyte ratio (NLR) is a simple and routinely obtained parameter reflecting systemic inflammation, including in peripheral artery disease (PAD).
Methods:
This systematic review aimed to assess the role of NLR as a prognostic biomarker in patients with PAD. A systematic search was conducted across PubMed, ScienceDirect, Web of Science, Scopus, ProQuest, EBSCO, and Cochrane. Random-effects meta-analysis was used to pool risk ratios, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). A bivariate model was used to generate summary receiver operating characteristics with the corresponding area under the curve (AUC).
Results:
This review included 5243 patients with PAD from nine eligible studies. High NLR corresponded to at least a twofold increased risk of all-cause mortality (ACM), major adverse limb events (MALE), and major adverse cardiovascular events (MACE). NLR’s performance was good for predicting 1-year ACM (AUC 0.71 [95% CI: 0.59–0.79], sensitivity 58.2% [95% CI: 45.3–71.0], specificity 72.6% [95% CI: 65.6–79.62], PPV 41.0% [95% CI: 31.2–50.7], NPV 82.7% [95% CI: 74.1–91.3]) and 1-year MALE (AUC 0.78 [95% CI: 0.75–0.80], sensitivity 65.4% [95% CI: 41.6–89.2], specificity 77.7% [95% CI: 71.0–84.3], PPV 53.7% [95% CI: 47.3–60.1], NPV 83.91% [95% CI: 73.2–94.6]). However, these values tended to decrease as the follow-up duration extended, except for the pooled specificities, which exhibited the opposite pattern.
Conclusion:
NLR emerges as a simple and cost-effective prognostic biomarker with decent performance for poor outcomes in patients with PAD (PROSPERO Registration No.: CRD42023486607).</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>39415502</pmid><doi>10.1177/1358863X241281699</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0002-7156-7827</orcidid><orcidid>https://orcid.org/0000-0002-5628-1345</orcidid><orcidid>https://orcid.org/0000-0002-3501-1872</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1358-863X |
| ispartof | Vascular medicine (London, England), 2024-12, Vol.29 (6), p.687-699 |
| issn | 1358-863X 1477-0377 1477-0377 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11590382 |
| source | Access via SAGE; MEDLINE; Alma/SFX Local Collection |
| subjects | Aged Biomarkers Biomarkers - blood Bivariate analysis Female Humans Leukocytes (neutrophilic) Lymphocyte Count Lymphocytes Lymphocytes - cytology Male Males Meta-analysis Middle Aged Neutrophils Neutrophils - cytology Original s Peripheral Arterial Disease - blood Peripheral Arterial Disease - diagnosis Peripheral Arterial Disease - immunology Peripheral Arterial Disease - mortality Predictive Value of Tests Prognosis Risk Assessment Risk Factors Sensitivity analysis Systematic review Vascular diseases Vein & artery diseases |
| title | Neutrophil-to-lymphocyte ratio as a prognostic biomarker in patients with peripheral artery disease: A systematic review and meta-analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-30T22%3A48%3A45IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Neutrophil-to-lymphocyte%20ratio%20as%20a%20prognostic%20biomarker%20in%20patients%20with%20peripheral%20artery%20disease:%20A%20systematic%20review%20and%20meta-analysis&rft.jtitle=Vascular%20medicine%20(London,%20England)&rft.au=Kurniawan,%20Roy%20B&rft.date=2024-12-01&rft.volume=29&rft.issue=6&rft.spage=687&rft.epage=699&rft.pages=687-699&rft.issn=1358-863X&rft.eissn=1477-0377&rft_id=info:doi/10.1177/1358863X241281699&rft_dat=%3Cproquest_pubme%3E3117617290%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3132910979&rft_id=info:pmid/39415502&rft_sage_id=10.1177_1358863X241281699&rfr_iscdi=true |