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

Abstract

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.

Combined Use of Neutrophil to Lymphocyte Ratio and C-Reactive Protein Level to Predict Clinical Outcomes in Acute Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention

“…PLR is also known as a good prognostic marker for cardiovascular events 21)22). In a previous study, combined NLR and PLR levels also predicted severity of CAD23) and adverse clinical outcomes 24). In our study, PLR was also a good predictor for all-cause death during 24 months of follow-up, and the AUC of PLR was similar to that of combined NLR and CRP.…”

The Association between Platelet/Lymphocyte Ratio and Coronary Artery Disease Severity in Asymptomatic Low Ejection Fraction Patients

“…Acar et al20) demonstrated that high PLR is related with coronary collateral development in patients with chronic total occlusions. Sarı et al21) revealed that pre-procedural PLR is associated with coronary atherosclerosis severity.…”

A Novel Index for Prompt Prediction of Severity in Patients with Unstable Angina Pectoris

“…PLR is calculated from systemic inflammatory markers as a predictor of poor cardiovascular outcomes [11]. Recent studies have demonstrated that the PLR is associated with MACE and that it is an independent marker of mortality in some oncological and cardiac diseases [12,23,24].…”

“…Platelets play a key role in the pathophysiology of ACS. Higher levels of inflammatory markers are associated with the severity of coronary artery disease (CAD) and worse cardiovascular outcome [11]. e platelet-lymphocyte ratio (PLR), which is calculated by the division of absolute platelet count by absolute lymphocyte count, has been stated to be a new indicator of inflammatory response.…”