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The neutrophil to lymphocyte (N/L) ratio is a recently described independent predictor of death/myocardial infarction in patients who have undergone coronary angiography. We hypothesized that an elevated N/L ratio would be a predictor of long-term mortality in patients undergoing percutaneous coronary intervention (PCI). A total of 1,046 patients who underwent PCI were divided into tertiles based on their preprocedural N/L ratio (mean N/L ratio, tertile 1, 1.7 ± 0.5; tertile 2: 3.2 ± 0.6; tertile 3, 11.2 ± 12.9). Vital status was assessed using the Social Security Death Index. There were a total of 144 deaths over a mean follow-up of 32 months. The best survival was seen in tertile 1, with an increase in long-term mortality seen in tertiles 2 and 3 (p <0.0001). In multivariable modeling, after adjusting for age, chronic obstructive pulmonary disease, left ventricular ejection fraction, serum hemoglobin, serum creatinine, and …