The Relationship Between Lymphocyte-to-Monocyte Ratio and Bare-Metal Stent In-Stent Restenosis in Patients With Stable Coronary Artery Disease

Abstract

In-stent restenosis (ISR) is a common clinical problem in patients with coronary artery disease treated with percutaneous coronary intervention. Inflammatory process plays a pivotal role in the development of ISR. Both lymphocytes and monocytes are associated with inflammatory status. Recently, it has been shown that the lymphocyte-to-monocyte ratio (LMR) is a novel inflammatory marker. We aimed to investigate the association of serum LMR levels and ISR in patients undergoing bare-metal stent (BMS) implantation. The study included 273 patients (aged 61 ± 11 years, 66.5% men) with a history of BMS implantation and a further control coronary angiography due to stable angina pectoris. Patients were divided into 2 groups: patients with and without ISR. The LMR levels were significantly lower in patients with ISR than in those without ISR (2.50 ± 0.95 vs 3.87 ± 1.51, respectively, P < .001). On multivariate logistic regression analysis, the LMR was independently associated with ISR (odds ratio [OR]: 0.310, 95% confidence interval: 0.166-0.579, P < .001) together with high-sensitivity C-reactive protein (OR: 1.244, P = .008), reason for stent implantation (OR: 6.566, P = .003), stent diameter (OR: 0.015, P < .001), and stent length (OR: 1.137, P = .007). In conclusion, LMR levels are inversely related to ISR in patients treated with BMS implantation.

Association of lymphocyte to monocyte ratio with severity of coronary artery disease

“…[ 27 ] In another recent study, the relationship between LMR and bare-metal in-stent restenosis in patients with SCAD was reported. [ 28 ] This study supports that LMR, as an inflammatory biomarker, contributes to the development of atherosclerosis from initiation through progression. More recently, Ji et al found that monocyte to lymphocyte ratio predicts the severity of CAD by a syntax score assessment.…”

Association of lymphocyte-to-monocyte ratio with in-hospital and long-term major adverse cardiac and cerebrovascular events in patients with ST-elevated myocardial infarction

“…[ 6 , 7 ] In addition, lymphocyte-to-monocyte ratio (LMR) has been recently studied that it was a novel marker of inflammation related to coronary artery disease. [ 8 ] Major adverse cardiac and cerebrovascular events (MACCE), which comprise stroke/transient ischemic attack (TIA), target vessel revascularization (TVR), nonfatal MI, and cardiovascular mortality, are very important adverse events associated with prognosis in patients with MI. In this study, we evaluated the relations between LMR and in-hospital and long-term MACCE in STEMI patients who underwent primary PCI to assess the prognostic value of LMR for STEMI.…”

The Role of Albumin in Bare Metal In-Stent Restenosis

“…[5][6][7][8] Recently, the neutrophil-to-lymphocyte ratio, platelet-tolymphocyte ratio, and lymphocyte-to-monocyte ratio have been used as independent predictors of in-stent restenosis. [9][10][11] However, Celik et al 1 did not evaluate the combinations of these easily calculated inflammatory markers. Furthermore, they did not indicate which confounding factors were tested in the multivariate regression model.…”