Association Between Neutrophil to Lymphocyte Ratio and Severity of Coronary Artery Disease

Kaya, Hasan; Ertaş, Faruk; İslamoğlu, Yahya; Kaya, Zekeriya; Atılgan, Zuhal Arıtürk; Çil, Habib; Çalışkan, Ahmet; Aydın, Mesut; Oylumlu, Mustafa; Soydinç, Mehmet Serdar

doi:10.1177/1076029612452116

Cited by 151 publications

(127 citation statements)

References 20 publications

Supporting

Mentioning

113

Contrasting

Unclassified

Order By: Relevance

“…In that study of 287 patients, the NLR was found to be significantly correlated with the SYNTAX score in both the ST elevation myocardial infarction (STEMI) and NSTE-ACS groups 35) . Furthermore, three other studies reported this relationship in SAP populations 15,36,37) . Kaya H. et al 36) used the Gensini score, whereas Sönmez O. et al 15) and Kaya A. et al 37) used the SYNTAX score, to assess the severity and complexity of CAD.…”

Section: Resultsmentioning

confidence: 63%

“…Furthermore, three other studies reported this relationship in SAP populations 15,36,37) . Kaya H. et al 36) used the Gensini score, whereas Sönmez O. et al 15) and Kaya A. et al 37) used the SYNTAX score, to assess the severity and complexity of CAD. Rather consistently, the NLR was found to be an independent predictor of a high Gensini or SYNTAX score in these studies.…”

Section: Resultsmentioning

confidence: 63%

“…However, investigators have only begun to study the relationships between the NLR and the Gensini or SYNTAX score to assess the complexity or severity of CAD within the last several years 15,[34][35][36][37] . For example, Tanındı A. et al 34) investigated the relationships between the NLR and the severity and complexity of CAD (as assessed according to the Gensini and SYNTAX scores) as well as myocardial perfusion (based on the myocardial blush grade) in 151 stable angina pectoris (SAP) or ACS patients and concluded that the NLR was significantly correlated with the Gensini and SYNTAX scores in both groups.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting the Severity of Coronary Artery Disease: A Gensini Score Assessment

Chen

et al. 2014

JAT

View full text Add to dashboard Cite

Aim:The usefulness of the white blood cell (WBC) count and neutrophil-to-lymphocyte ratio (NLR) in predicting the severity of stable coronary artery disease (CAD) has not been sufficiently evaluated, particularly based on strict coronary assessments. The aim of the present study was to investigate the WBC count and NLR in predicting the severity of angiographically proven CAD. Methods: A total of 2,976 CAD patients and 571 non-CAD patients were consecutively enrolled, and the CAD patients were classified into the three groups according to the tertile of the Gensini score (GS, low GS＜18, n = 989; intermediate GS 18-41, n = 995 and high GS＞41, n = 992). The efficacy of the WBC count and NLR in predicting the risk and severity of CAD as well as the correlations between these markers and the GS were analyzed. A receiver operating characteristic (ROC) curve analysis was also performed. Results: The NLR was found to be an independent predictor of both the presence of CAD (OR = 1.18, 95%CI: 1.09-1.27, p = 0.009) and a high GS (OR=1.10, 95%CI: 1.01-1.16, p = 0.032). In addition, there were mild positive correlations between the GS and the NLR, WBC and proportions of neutrophils and monocytes. In the ROC curves analysis, the NLR was found to have the largest area under the curve (AUC = 0.63, 95%CI: 0.59-0.67, p=0.000), with an optimal cut-off value of 2.04 (sensitivity: 62.1%, specificity: 54.8%) for predicting a high GS. Conclusions: The NLR is a valuable independent predictor of the severity of CAD assessed according to the GS. In particular, an NLR of ＞2.04 indicates a higher risk of CAD and greater severity of CAD lesions. Hypertension was diagnosed based on repeated blood pressure measurements of ≥ 140/90 mmHg (at least two times in different environments) or the use of antihypertensive drugs. DM was diagnosed based on a fasting serum glucose level of ≥ 6.99 mmol/L on multiple occasions and/or the use of insulin or oral hypoglycemic agents. Dyslipidemia was diagnosed according to a fasting total cholesterol level of (TC) ≥ 200 mg/dL or triglyceride (TG) level of ≥150 mg/dL. J Atheroscler Laboratory TestsAll baseline laboratory data were acquired from venous blood samples obtained after a 12-hour overnight fast prior to coronary angiography. The levels of WBC, neutrophils, lymphocytes and monocytes were determined using an automated blood cell counter, the Coulter LH780 Hematology Analyzer (Beckman Coulter Ireland Inc. Mervue, Galway, Ireland), and the levels of high-sensitivity C-reactive protein (hs-CRP) were assessed using immunoturbidimetry (Beckmann Assay 360, Bera, California, USA), as previously reported 16,17) . The NLR was calculated as the ratio of neutrophils to lymphocytes, the levels of which were obtained from the same blood samples. The normal range of hs-CRP in our hospital laboratory is 0-3 mg/L. Angiographic ExaminationsSelective coronary angiography was performed in all enrolled subjects using the standard Judkin's technique, and the results were analyzed by at least two interventional physicians w...

show abstract

Section: Resultsmentioning

confidence: 63%

Section: Resultsmentioning

confidence: 63%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting the Severity of Coronary Artery Disease: A Gensini Score Assessment

Chen

et al. 2014

JAT

View full text Add to dashboard Cite

show abstract

“…Previous studies have shown that severity of CAD is correlated with higher NLR value. Kaya et al [20] showed that NLR is a predictor of severe atherosclerosis, which may be useful for cardiac risk stratification in patients with CAD. They showed significant correlation between NLR and GENSINI score.…”

Section: Discussionmentioning

confidence: 99%

Relation of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio with coronary artery disease severity in patients undergoing coronary angiography

et al. 2015

View full text Add to dashboard Cite

A b s t r a c tBackground: Atherosclerosis is a chronic systemic inflammatory disease. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are systemic inflammatory markers that are correlated with poor cardiovascular outcomes. Aim:To explore the relation of NLR and PLR with severity of coronary artery disease (CAD). Methods:The study population consisted of 180 consecutive patients who underwent elective coronary angiography (CAG). While 100 patients (22 female, mean age: 60.6 ± 12.6 years) had abnormal CAG, 80 patients (44 female, mean age: 57.2 ± 10.9 years) had normal CAG. NLR and PLR were calculated as the ratio of neutrophil count to lymphocyte count and as the ratio of platelet count to lymphocyte count, respectively. Results:Although age distribution was similar between the two groups (p = 0.073), female gender was significantly higher in the normal CAG group (p < 0.001). Patients with abnormal CAG had significantly higher NLR and PLR when compared to patients with normal CAG (3.7 ± 2.6 vs. 2.2 ± 1.7, p < 0.001 and 125.9 ± 72.3 vs. 102.6 ± 33.8, p = 0.027, respectively). NLR and PLR were significantly correlated with SYNTAX score and GENSINI score. In logistic regression analyses, only NLR (odds ratio: 1.576, confidence interval: 1.198-2.072, p = 0.001) was an independent predictor of CAD. An NLR of 2.3 or higher predicted the CAD with a sensitivity of 66% and specificity of 70%.Conclusions: NLR and PLR seem to be a simple method to predict severity of CAD in patients undergoing elective CAG, and it may be part of cardiovascular examination before CAG.

show abstract

“…NLR has been shown to predict short and longterm mortality in patients with both ST and non-ST elevation myocardial infarction and in patients undergoing percutaneous coronary interventions. 10,11,17,18 NLR has also been shown to be predict severity of coronary artery disease 19 and patency of bare metal stents after percutaneous coronary interventions and saphenous vein grafts after coronary artery bypass surgery. 20,21 Despite this, relatively few studies have investigated the NLR in patients with chronic kidney disease.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil–lymphocyte ratio predicts cardiovascular and all-cause mortality in hemodialysis patients

et al. 2015

View full text Add to dashboard Cite

Neutrophil-lymphocyte ratio (NLR) is a marker of systemic inflammation that has been shown to predict mortality in patients with malignancies, ischemic heart disease and peripheral vascular disease. Its prognostic value in hemodialysis patients is unclear. The aims of this study were to: (i) explore the relationship between NLR and other biochemical parameters and (ii) to examine the value of NLR as a predictor of cardiovascular and all-cause mortality in hemodialysis patients. The study included all the incident hemodialysis patients from a single center between 2007 and 2012. NLR was calculated using samples obtained 3 months after commencing hemodialysis. One hundred seventy hemodialysis patients were included with a median follow-up of 37 months. There were 54 deaths (32%). NLR was positively correlated with C-reactive protein (r ¼ 0.24, p ¼ 0.0023) and negatively correlated with hemoglobin (r ¼ À0.27, p ¼ 0.00048), albumin (r ¼ À0.23, p ¼ 0.0034) and total cholesterol (r ¼ À0.17, p ¼ 0.049) levels. In multivariate Cox regression, NLR was independently associated with both all-cause mortality (adjusted hazard ratio [HR] 1.4; 95% confidence interval [CI], 1.2-1.6; p 0.0001) and cardiovascular death (HR 1.3, 95% CI 1.1-1.6, p ¼ 0.0032). Other predictors of all-cause mortality were age (HR 1.6 per decade; 95% CI, 1.2-2.1; p ¼ 0.0017), body mass index (HR 0.93; 95% CI, 0.88-0.98; p ¼ 0.0047), albumin (HR 0.91; 95% CI, 0.86-0.97; p ¼ 0.0035) and peripheral vascular disease (HR 2.7; 95% CI, 1.4-5.1; p ¼ 0.0023). NLR is a practical, cost-efficient and easy to use predictor of cardiovascular and all-cause mortality in incident hemodialysis patients.

show abstract

Association Between Neutrophil to Lymphocyte Ratio and Severity of Coronary Artery Disease

Cited by 151 publications

References 20 publications

Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting the Severity of Coronary Artery Disease: A Gensini Score Assessment

Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting the Severity of Coronary Artery Disease: A Gensini Score Assessment

Relation of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio with coronary artery disease severity in patients undergoing coronary angiography

Neutrophil–lymphocyte ratio predicts cardiovascular and all-cause mortality in hemodialysis patients

Contact Info

Product

Resources

About