Neutrophil-to-lymphocyte ratio predicts hemodynamic significance of coronary artery stenosis

Abstract

Objective:Coronary artery disease is closely linked with inflammation, and the neutrophil-to-lymphocyte ratio (NLR) has emerged as a new inflammatory marker. Fractional flow reserve (FFR) is a well-established method for determining hemodynamic significance of coronary artery stenosis. In this study, we aimed to investigate the relationship between NLR and hemodynamic significance of coronary artery lesion as assessed by FFR.Methods:A total of 134 patients with FFR measurement between January 2012 and December 2013 were enrolled in this retrospective study. Patients with single intermediate-grade coronary artery stenosis were enrolled, and those with second intermediate or severe coronary artery stenosis were excluded from study. Patients’ NLR were calculated. An FFR value of <0.80 was accepted for hemodynamic significance. Statistical analysis was performed by the chi-square test, Student’s t-test, Mann–Whitney U test, logistic regression analysis, and ROC curve analysis.Results:Patients with hemodynamically significant lesions had higher NLR values (3.3±1.2 vs. 2.0±0.9, p<0.001). White blood cell count, male gender, high-density lipoprotein levels, platelet-to-lymphocyte ratio, and NLR were found to be possible confounding factors predicting hemodynamically significant coronary artery stenosis. In multiple logistic regression analysis, NLR remained as the only independent predictor for hemodynamically significant coronary artery stenosis. An NLR value of 2.4 had 87.5% sensitivity and 78.4% specificity for prediction of hemodynamically significant coronary artery stenosis.Conclusion:In present study, we showed that NLR was significantly higher in patients with hemodynamically significant coronary artery stenosis. We also found NLR to be an independent predictor of hemodynamically significant coronary artery stenosis as measured by FFR. Further studies are needed to find a causal relationship.

Use of the Monocyte-to-Lymphocyte Ratio to Predict Diabetic Retinopathy

“…Many studies have reported positive correlations of conventional inflammatory markers with the PLR and NLR. More importantly, a large number of studies found predictive effects of the PLR and NLR, particularly in DM, acute coronary syndromes, and various cancers [ 9 , 10 , 12 , 13 , 36 ]. However, as an immune indicator, the only study on MLR focused on malaria [ 14 ].…”

“…The white blood cell (WBC) count and its subtypes are classic indicators of inflammation [ 8 ]. The platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and neutrophil-to-lymphocyte ratio (NLR) are potential markers of inflammation in various conditions, including tumors [ 9 , 10 , 11 ], cardiovascular conditions [ 12 , 13 ] and other diseases [ 14 ].…”

Monocyte to HDL ratio as an indicator of subclinical atherosclerosis in diabetic retinopathy

“…In many studies, conventional inflammatory markers had positive correlation with PLR and NLR. Besides, in many studies, in especially DM patients, PLR and NLR had predictive effects on acute coronary syndrome (16,17). In addition, only one study has been performed that included MLR in diabetic retinopathy as an immune marker.…”

Association of neutrophil/lymphocyte ratio with obstructive coronary artery disease and coronary artery calcium score detected by multislice computed tomography in type 2 diabetes mellitus patients

“…NLR was found to be an independent predicting factor for hemodynamically significant coronary artery stenosis as measured by fractional flow reserve (FFR). 19 …”