Neutrophil to lymphocyte ratio is associated with more extensive, severe and complex coronary artery disease and impaired myocardial perfusion [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2014; 42(2): 125-130 | DOI: 10.5543/tkda.2014.18949

Neutrophil to lymphocyte ratio is associated with more extensive, severe and complex coronary artery disease and impaired myocardial perfusion

Aslı Tanındı1, Aycan Fahri Erkan1, Berkay Ekici1, Aslıhan Alhan2, Hasan Fehmi Töre1
1Department of Cardiology, Ufuk University Faculty of Medicine, Ankara
2Department of Statistics, Ufuk University Faculty of Arts and Sciences, Ankara


OBJECTIVES
We investigated the relation between neutrophil to lymphocyte ratio (N/L) and the extent, severity, and complexity of coronary artery disease (CAD) and myocardial perfusion.

STUDY DESIGN
One hundred and fifty-one patients who underwent coronary angiography with stable angina pectoris (SAP) (n=93) or acute coronary syndrome (ACS) (n=58) were included in the study. Blood samples were drawn before coronary angiography. Gensini and SYNTAX scores and myocardial blush grade (MBG) were assessed.

RESULTS
Neutrophil counts were 4.4±1.4 and 5.0±1.6 in the SAP and ACS groups (p=0.018), whereas lymphocyte counts were 2.2±0.7 and 2.1±0.7, respectively (p=0.104). N/L was 2.2±1.2 in the SAP and 2.6±1.0 in the ACS (p=0.002) groups. In patients with SAP, N/L was significantly correlated with Gensini and SYNTAX scores (Gensini score r=0.32, p=0.002; SYNTAX score r=0.36, p=0.000), but there was no significant correlation between N/L and MBG. In the ACS group, N/L had a more powerful association with both Gensini and SYNTAX scores (Gensini r=0.42, p=0.001; SYNTAX r=0.51, p=0.000). N/L was negatively correlated with MBG in ACS patients (r= -0.48, p=0.000). Significant correlations persisted both in the SAP and ACS groups after correcting for age, diabetes, hyperlipidemia, and statin use; however, the associations were weaker. Cut-off N/L to predict moderate to severe CAD according to SYNTAX score was 2.26, with 72% sensitivity and 71% specificity (area under the curve [AUC]: 0.772, 95% confidence interval [CI] 0.679-0.865, p<0.001).

CONCLUSION
N/L is associated with severe, extensive and complex CAD and may be used to predict moderate to severe involvement in patients with CAD.

Keywords: Coronary angiography, coronary artery disease; leukocyte count; leukocytosis/blood; myocardial infarction/therapy; neutrophils.

How to cite this article
Aslı Tanındı, Aycan Fahri Erkan, Berkay Ekici, Aslıhan Alhan, Hasan Fehmi Töre. Neutrophil to lymphocyte ratio is associated with more extensive, severe and complex coronary artery disease and impaired myocardial perfusion. Turk Kardiyol Dern Ars. 2014; 42(2): 125-130

Corresponding Author: Aslı Tanındı, Türkiye
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