The Correlation between Neutrophil Lymphocyte Ratio, C-reactive Protein, and Serum Amyloid a with the Degree of Stenosis in Acute Coronary Syndrome

Abstract

BACKGROUND: Inflammation plays a central role in the pathophysiology of acute coronary syndrome (ACS), involving neutrophils as non-specific markers of inflammation and lymphocytes as regulatory markers, measured in the form of neutrophil lymphocyte ratio (NLR). C-reactive protein (CRP) plays a role in the blockage of heart arteries and serum amyloid A (SAA) plays a role in the pathophysiology of coronary stenosis.
 AIM: The study aimed to determine the correlation between NLR, CRP, and SAA levels with the degree of coronary artery stenosis in ACS.
 METHOD: The design of this study was cross-sectional. The target population in this study was patients with ACS in Dr. Kariadi Hospital Semarang. We performed an NLR measurement with a hematologic analyzer, CRP, and SAA levels using the ELISA method, and coronary angiography using the Gensini score. Furthermore, we also performed the Spearman correlation test between variables.
 RESULTS: The median (min; max) values of NLR, CRP, SAA levels, and Gensini score were 4.39 ± 0.48 (0.36; 18.17); 8.63 ± 2.22 (5; 105.11) mg/dL; 36.859 (3.909–69.724); 65 (6–178), respectively. The correlation between NLR, CRP, and SAA levels with the Gensini scores was r = 0.064, p = 0.595; r = 0.240, p = 0.044; r = −0,164, p = 0.171, respectively.
 CONCLUSION: CRP measurement could be used as a marker of inflammation in ACS to manage the inflammation process. Furthermore, SAA levels were clinically useful biomolecular parameters in evaluating acute inflammation in ACS, although it did not correlate with the Gensini scores.