Neutrophil‐to‐lymphocyte ratio as a cardiovascular risk biomarker in psoriasis: A comprehensive review

Abstract

Background Psoriasis is a chronic and inflammatory cutaneous disease and it is associated with high cardiovascular risk (CVR). Studies have demonstrated that neutrophils may play a role in CVR in psoriasis. Neutrophil‐to‐lymphocyte ratio (NLR) is a readily available inflammatory biomarker that predicts the development of psoriasis and psoriatic arthritis and is associated with atherosclerosis and cardiovascular (CV) events. Objectives The aim of this review is to analyze the association between NLR and the presence or risk to develop cardiovascular disease (CVD) in psoriasis patients. Methods A comprehensive literature research was carried out through Pubmed, Embase and Web of Science to identify all the evidence related to NLR and CVD in psoriasis population. We enrolled all cohort, case‐control and cross‐sectional studies. Duplicated articles and papers without sufficient data were excluded after a full‐text review. Only articles published in English were enrolled in this study. Results primary searches identified 9 relevant articles. We included 1 observational, 5 case‐control and 3 cross‐sectional studies. NLR was assessed in all studies. As a whole, even though there is a paucity of published evidence, NLR was associated with an increased risk of subclinical atherosclerosis and CVD in all the articles included in this review. The main differences among studies were the sample size and the article design. Conclusion this review found that NLR is a simple, universally available and routine low‐cost biomarker able to predict CV events in patients with psoriasis. This test will help dermatologists to early detect those patients with psoriasis in whom there is a higher risk of CVD, who can benefit from preventive strategies and treatment settings.

Novel biomarkers and psoriasis associated cardiovascular risk: a population-based study

“…Focusing on other novel CVR parameters, elevated values of NLR 2,07 ± 1,15 and PLR 124,68 ± 39,82 were obtained, as previously described as novel CVR biomarkers in psoriasis (4).…”

“…Traditional CVR assessment tools, such as the Framingham Risk Score, may underestimate the true risk in individuals with psoriasis due to the unique pathophysiological mechanisms involved. Hence, there is a growing interest in identifying novel biomarkers that can better predict CVR speci cally in psoriasis patients (4,5).…”

Predictive Biomarkers of Thyroid Dysfunctions Associated with the Treatment of Non-Small Cell Lung Cancer and Cervical Cancer with Immune Checkpoint Inhibitors

“…8 Complete blood count-derived inflammatory markers have recently been used as prognostic markers in oncology, cardiovascular, autoimmune, and other diseases. 9,10 In addition, there are several studies where ANC (absolute neutrophil count), NLR, and dNLR have been addressed as the independent predictors of survival in cancer patients, prognostic biomarkers of therapeutic response to biologics in autoimmune disease, and predictive role for the risk of preterm delivery, etc. 11,12,13 As the symptoms of hypothyroidism mimic those of cancer, the diagnosis of thyroid dysfunction may be missed, leading to lifethreatening complications.…”

Effect of Elevated Neutrophil-to-Lymphocyte Ratio on Adverse Outcomes in Patients With Myocardial Infarction: A Systematic Review and Meta-Analysis

“…Furthermore, NLR serves as a readily available and cost-effective biomarker, making it particularly attractive for risk stratification in clinical practice. Its simplicity, coupled with its prognostic significance, underscores its potential as a valuable tool for identifying patients with high-risk MI who may benefit from intensified therapeutic interventions and closer monitoring to mitigate the risk of MACE [ 50 ]. Overall, the NLR holds promise as a clinically relevant biomarker for predicting MACE in individuals with MI, offering valuable insights into the pathophysiology of cardiovascular disease and opportunities for optimizing patient management strategies.…”