Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio as Predictors of Coronary Microcirculatory Disease Occurrence and Outcome in Patients With Chronic Coronary Syndrome and No Significant Coronary Artery Stenosis

Abstract

Introduction: Index of microcirculatory resistance assessment is an invasive method of measuring coronary microcirculation function. Association between impaired microcirculatory function and higher rate of cardiovascular events was proven. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio seem to be a promising parameters to predict coronary microcirculatory disease in patients with chronic coronary syndrome. The aim: To determine neutrophil-lymphocyte ratio and platelet-lymphocyte ratio levels in patients with coronary microcirculatory disease and potential association with clinical outcome. Material and methods: 82 consecutive patients with mean age of 67 years, 67% male, were tested for presence of coronary microcirculatory disease using index of microcirculatory resistance. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio were calculated based on admission full blood count. Follow-up with major adverse cardiac and cardiovascular events registration was performed (median 24 months). Results: The study showed significantly higher neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in patients with coronary microcirculatory disease compared to control group (3.58±2.61 vs 2.54±1.09 and 164±87.9 vs 124±36.6 respectively). Higher level of platelet-lymphocyte ratio in patients with coronary microcirculatory disease results in worse MACCE-free survival. Optimal cut-off values of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio to detect coronary microcirculatory disease were 3.2 and 181.3, respectively. Conclusions: Higher neutrophil-lymphocyte ratio and platelet-lymphocyte ratio are associated with increased index of microcirculatory resistance value. Platelet-lymphocyte ratio may be used as a predictor of worse outcome in patients with coronary microcirculatory disease.

The Neutrophil/Lymphocyte Ratio is Associated with Different Stages of Development of Coronary Artery Disease

“…According to recent studies, NLR is a powerful systemic inflammatory indicator associated with the prevalence and severity of CAD [10,11]. Our study showed higher NLR levels in CAD, including CCS and particularly AMI.…”

Hemoglobin/Red Cell Distribution Width Ratio is Associated With Poor Prognosis in Patients With Acute Coronary Syndrome in Long-Term Follow-Up

“…The prognostic importance of complete blood count parameters (neutrophil/ lymphocyte ratio, platelet/lymphocyte ratio, mean platelet volume, and neutrophil/monocyte) in coronary artery disease (CAD) has been demonstrated in many studies. [10][11][12] Hemoglobin (Hb) is generally used to define anemia along with other parameters such as hematocrit. However, recent works suggest that Hb is also a predictor of hospital admission of subjects with chronic diseases.…”