Neutrophil-to-Lymphocyte Ratio Is Not Associated with Severity of Coronary Artery Disease and Is Not Correlated with Vitamin D Level in Patients with a History of an Acute Coronary Syndrome

Abstract

Coronary artery disease (CAD), the leading cause of death worldwide, has an underlying cause in atherosclerosis. The activity of this inflammatory process can be measured with neutrophil-to-lymphocyte ratio (NLR). The anti-inflammatory and anti-atherogenic properties of vitamin D affect many mechanisms involved in CAD. In this study, we investigated the association between NLR, vitamin D concentration, and severity of CAD in a group of patients with a history of myocardial infarction (MI). NLR was higher in patients with acute coronary syndrome (ACS) in comparison to those with stable CAD (median: 2.8, range: 0.96–24.3 vs. median: 2.3, range: 0.03–31.6; p < 0.05). No associations between NLR and severity of CAD (p = 0.14) in the cohort and in the subgroups with stable CAD (p = 0.40) and ACS (p = 0.34) were observed. We found no correlation between vitamin D level and NLR neither in the whole study group (p = 0.29) nor in subgroups of patients with stable CAD (p = 0.84) and ACS (p = 0.30). NLR could be used as prognostic biomarker of consecutive MI in patients with CAD and a history of MI.

Investigation of the Associations of Novel Inflammatory Biomarkers—Systemic Inflammatory Index (SII) and Systemic Inflammatory Response Index (SIRI)—With the Severity of Coronary Artery Disease and Acute Coronary Syndrome Occurrence

“…Notably, the highest values of SII and SIRI were observed for patients with the highest stage of CAD, i.e., in patients with CASSC 3 in comparison to those with CASSC 0–2. In our previous study, we described significantly higher NLR values in patients undergoing coronary angiography due to subsequent ACS with a history of previous ACS compared to patients with stable CAD [ 44 ], as well as a lack of significant differences in platelet activity parameters (MPV and P-LCR) between these two groups [ 45 ]. In addition, the group of patients with three-vessel CAD had the highest NLR, but without statistical significance [ 44 ].…”

The Association between Serum Vitamin D Concentration and New Inflammatory Biomarkers—Systemic Inflammatory Index (SII) and Systemic Inflammatory Response (SIRI)—In Patients with Ischemic Heart Disease

“…This research assessed the correlation between serum vitamin D concentrations with new inflammatory markers—SIRI and SII—in a group of nearly 700 patients undergoing coronary angiography due to suspicion of ACS. This article is a continuation of a project analyzing blood cell counts as biomarkers of subclinical inflammation in IHD [ 73 , 74 ]. The previously presented data revealed that SII and SIRI were significantly higher in patients with diagnosed ACS compared with those in patients with stable IHD [ 21 ].…”

Blood Count-Derived Inflammatory Markers and Acute Complications of Ischemic Heart Disease in Elderly Women

“…Previously, we found an association between higher SII and SIRI with diagnosed ACS in a cohort of nearly 700 patients with chest pain [ 23 ]. Furthermore, analysis of patients with a history of myocardial infarction revealed higher values of NLR in patients with consecutive ACS compared to those with stable CAD and a history of myocardial infarction [ 40 ]. However, all groups had similar platelet activity parameters (MPV and P-LCR) [ 41 ].…”