Relationship between Neutrophil-to-Lymphocyte Ratio and Plaque Components in Patients with Coronary Artery Disease: Virtual Histology Intravascular Ultrasound Analysis

Abstract

The aim of this study was to evaluate the relation between neutrophil-to-lymphocyte ratio (NLR) and plaque components assessed by virtual histology-intravascular ultrasound in 399 coronary artery disease (CAD) patients with 471 coronary lesions. We classified the lesions into two groups according to the NLR on admission {low NLR group (NLR≤2.73 [n=370]) vs. high NLR group (NLR>2.73 [n=101])}. By volumetric analysis, total atheroma and the absolute necrotic core (NC) volumes were significantly greater in high NLR group (249.9±149.7 µL vs. 192.5±127.7 µL, P=0.001, and 32.7±26.8 µL vs. 22.8±19.4 µL, P=0.001, respectively) and thin-cap fibroatheroma (TCFA) was observed more frequently in high NLR group (33% vs. 18%, P=0.001). ST segment elevation myocardial infarction (odds ratio [OR], 2.159; 95% CI, 1.000-4.660, P=0.050) and NLR>2.73 (OR, 1.848; 95% CI, 1.016-3.360, P=0.044) and total atheroma volume (OR, 1.003; 95% CI, 1.001-1.004, P=0.004) were the independent predictors of TCFA. CAD patients with high NLR had more vulnerable plaque components (greater NC-containing plaques) than those with low NLR.

Neutropenia and neutrophil‐to‐lymphocyte ratio in a healthy Korean population: race and sex should be considered

“…Several studies demonstrated that NLR is a significant predictor of adverse outcomes for patients with conditions such as acute cholecystitis, cardiovascular disease, cerebrovascular disease, malignancies, and sudden sensorineural hearing loss . In rheumatoid arthritis, NLR correlates with the disease activity score and high values are associated with chronic conditions such as diabetes, as well as with smoking and increased age .…”

Anemia and Inflammation in ST-Segment Elevation Myocardial Infarction

“… 25 Besides, among coronary artery disease patients, higher NLR usually indicate more vulnerable plaque components, which is closely associated with severe thrombus-related events. 26 …”

The relationship between neutrophil to lymphocyte ratio and artery stiffness in subtypes of hypertension

“…One meta‐analysis showed that the occurrence and reoccurrence of atrial fibrillation were significantly correlated with a high NLR . In addition, an increased NLR results in more vulnerable plaque and higher risk of thrombotic diseases . A follow‐up investigation of 248 patients who underwent primary percutaneous coronary intervention with ST‐segment elevation myocardial infarction reported that 36 patients experienced major adverse cardiovascular events .…”