Relationship of Neutrophil–Lymphocyte Ratio With the Presence, Severity, and Extent of Coronary Atherosclerosis Detected by Coronary Computed Tomography Angiography

Açar, Göksel; Fidan, Serdar; Uslu, Zulal Alnur; Turkday, Sevim; Avcı, Anıl; Alızade, Elnur; Kalkan, Mehmet; Tabakci, Omer Naci; Tanboğa, İbrahi̇m Hali̇l; Esen, Ali Metin

doi:10.1177/0003319714520954

Cited by 31 publications

(31 citation statements)

References 30 publications

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“…Our findings confirm the results reported by Kaya et al, in 186 patients undergoing coronary angiography, where NLR was related to the complexity of CAD assessed by SYNTAX score. 49 Similar conclusion was reached by Altun et al, 50 in a Scandinavian cohort of 287 patients with ACS, and by Açar et al 51 in 283 patients evaluated by coronary computed tomography, where NLR values in the third tertile increased the risk of CAD and the severity of critical luminal stenosis. Therefore, the present study provides a deeper insight into the stratification tools for assessing the risk of CAD and in the role of immune response in the pathogenesis of CAD, suggesting the hypothesis of immune modulation as a potential pharmacological target for the prevention of CV disease.…”

Section: Discussionsupporting

confidence: 65%

Neutrophil to Lymphocyte Ratio and the Extent of Coronary Artery Disease

et al. 2015

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The neutrophil to lymphocyte ratio (NLR), an inflammatory biomarker, may be of predictive and prognostic value for cardiovascular (CV) events. We evaluated the relationship of NLR with the prevalence and extent of coronary artery disease (CAD) in consecutive patients undergoing elective or urgent coronary angiography. Our population (n ¼ 3738 patients) was divided into NLR quartiles. Higher NLR was associated with aging and established CV risk factors, previous percutaneous coronary revascularization, acute presentation, and more complex pharmacological therapy. The NLR was related to platelet count, white blood cell count, creatinine, glycemia, uric acid, and C-reactive protein (all P ¼ .001) levels but inversely related to hemoglobin (P < .001), total cholesterol (P ¼ .005), and triglycerides (P < .001) levels. The NLR was associated with multivessel disease (P < .001), anterior descending, right coronary arteries (P < .001) or circumflex branch lesions (P ¼ .01), percentage of stenosis (P < .001), coronary calcification (P < .001), and intracoronary thrombus (P < .001) but inversely with in-stent restenosis (P < .001) and thrombolysis in myocardial infarction flow (P ¼ .04). The NLR was directly related to the prevalence of CAD (P ¼ .001) and severe CAD (P < .001). In patients undergoing coronary angiography, the NLR is independently associated with the prevalence and severity of CAD.

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Section: Discussionsupporting

confidence: 65%

Neutrophil to Lymphocyte Ratio and the Extent of Coronary Artery Disease

et al. 2015

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“…Among 17 studies of 8,988 subjects, 4 studies [ 14 , 16 , 20 , 23 ] reported ORs of high versus low NLR, 8 studies [ 10 – 12 , 17 , 19 , 21 , 22 , 26 ] reported mean differences of NLR between CAD and non-CAD patients, and 5 studies [ 13 , 15 , 18 , 24 , 25 ] reported both.…”

Section: Resultsmentioning

confidence: 99%

Neutrophil Lymphocyte Ratio and Cardiovascular Disease Risk: A Systematic Review and Meta-Analysis

Angkananard

Anothaisintawee

McEvoy

et al. 2018

BioMed Research International

238

181

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Objective This systematic review aimed to measure the association between neutrophil lymphocyte ratio (NLR) and cardiovascular disease (CVD) risk. Methods Relevant studies were identified from Medline and Scopus databases. Observational studies with NLR as a study factor were eligible for review. The outcomes of interest were any type of CVD including acute coronary syndrome, coronary artery disease, stroke, or a composite of these cardiovascular events. Mean differences in NLR between CVD and non-CVD patients were pooled using unstandardized mean difference (USMD). Odds ratios of CVD between high and low NLR groups were pooled using a random effects model. Results Thirty-eight studies (n=76,002) were included. High NLR was significantly associated with the risks of CAD, ACS, stroke, and composite cardiovascular events with pooled ORs of 1.62 (95% CI: 1.38-1.91), 1.64 (95% CI: 1.30, 2.05), 2.36 (95% CI: 1.44, 2.89), and 3.86 (95% CI: 1.73, 8.64), respectively. In addition, mean NLRs in CAD, ACS, and stroke patients were significantly higher than in control groups. Conclusion High NLR was associated with CAD, ACS, stroke, and composite cardiovascular events. Therefore, NLR may be a useful CVD biomarker.

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“…Moreover, several studies showed a relationship between low lymphocyte count and malnutrition [24, 25]. Thus, the combination of elevated neutrophils (nonspecific inflammation) and decreased levels of lymphocytes (regulatory component) into a single composite marker may provide additional information to interpret the pathogenesis of arterial stiffness [26]. However, there is an ongoing debate whether NLR is merely a surrogate marker of understanding inflammation, or whether it confers an increased risk per se [20].…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-lymphocyte ratio is associated with arterial stiffness in patients with peritoneal dialysis

et al. 2016

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BackgroundPatients with peritoneal dialysis are in the persistent inflammation state and have elevated arterial stiffness. Neutrophil-lymphocyte ratio(NLR) is a new inflammatory marker in renal and cardiac disorders. Brachial-ankle pulse wave velocity (baPWV) is a non-invasive measurement, which is widely used as a surrogate marker of arterial stiffness. However, there is little evidence to show an association between NLR and baPWV in patients with peritoneal dialysis. The aim of this cross-section study was to investigate the relationship between NLR and arterial stiffness measured by baPWV in patients with peritoneal dialysis.MethodsIn this cross-section study, 101 patients with peritoneal dialysis were enrolled from January 2014 to June 2015. According to average baPWV level (1847.54 cm/s), the patients were categorized into two groups, low group and high group. baPWV, which reflects arterial stiffness, was calculated using the single-point method. Clinical data were collected in details. NLR was calculated using complete blood count. Associations between NLR and baPWV were assessed using Pearson’s correlation and linear regression analysis.ResultsThe NLR was significantly lower in the low baPWV group than in the high baPWV group (p = 0.03). There were positive correlations between baPWV and neutrophil count (r = 0.24, p = 0.01) and NRL(r = 0.43, P < 0.01), and there was a negative correlation between baPWV and lymphocyte count (r = -0.23, p = 0.01). In addition, albumin, phosphorous and intact parathyroid hormone showed negative correlations with baPWV (r = −0.32, p < 0.01; r = −0.28, p < 0.01; r = −0.25, p = 0.01, respectively). Age and hsCRP showed positive correlations with baPWV (r = 0.47, p < 0.01; r = 0.25, p = 0.01). In multivariate analysis, NLR independently correlated with baPWV in patients with peritoneal dialysis (β = 0.33, p < 0.01), even after adjustment for various confounders.ConclusionOur study suggests that NLR was an independently associated with arterial stiffness in patients with peritoneal dialysis. However, further prospective studies are needed to confirm cause-and-effect relationship between NLR and baPWV, and to investigate whether anti-inflammatory treatment could improve arterial stiffness in patients with peritoneal dialysis.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-016-0394-4) contains supplementary material, which is available to authorized users.

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Relationship of Neutrophil–Lymphocyte Ratio With the Presence, Severity, and Extent of Coronary Atherosclerosis Detected by Coronary Computed Tomography Angiography

Cited by 31 publications

References 30 publications

Neutrophil to Lymphocyte Ratio and the Extent of Coronary Artery Disease

Neutrophil to Lymphocyte Ratio and the Extent of Coronary Artery Disease

Neutrophil Lymphocyte Ratio and Cardiovascular Disease Risk: A Systematic Review and Meta-Analysis

Neutrophil-lymphocyte ratio is associated with arterial stiffness in patients with peritoneal dialysis

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