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The relationship between coronary collateral circulation and neutrophil/lymphocyte ratio in patients with coronary
Alper Bugra Nacar1, Ali Erayman, Mustafa Kurt
1Department of Cardiology, School of Medicine, Mustafa Kemal University, Hatay, Turkey.
Insights
The neutrophil-to-lymphocyte ratio (NLR) is linked to poor coronary collateral circulation (CCC) in chronic total occlusion patients. Higher NLR indicates impaired CCC development, suggesting its potential as a predictive biomarker.
Area of Science:
- Cardiology
- Hematology
Background:
- Coronary artery disease (CAD) with chronic total occlusion (CTO) presents challenges in treatment and outcomes.
- Coronary collateral circulation (CCC) plays a crucial role in mitigating ischemia in CTO patients.
- The neutrophil-to-lymphocyte ratio (NLR) is an emerging inflammatory marker with potential implications in cardiovascular diseases.
Purpose of the Study:
- To investigate the association between NLR and the development of CCC in patients with coronary CTO.
- To evaluate NLR as a potential predictor of impaired CCC in this patient cohort.
Main Methods:
- A study included 138 patients diagnosed with coronary CTO.
- Patients were categorized into groups with impaired CCC (Rentrop grades 0-1) and good CCC (Rentrop grades 2-3).
- NLR was calculated from complete blood count data; other clinical parameters were also assessed.
Main Results:
- Patients with impaired CCC exhibited significantly higher NLR values compared to those with good CCC (4.5 ± 0.7 vs. 2.7 ± 0.6, p < 0.001).
- Multivariate analysis identified NLR as an independent predictor of impaired CCC (OR 33.36, p < 0.001).
- An NLR cutoff of >3.55 demonstrated high sensitivity (95%) and specificity (90%) for predicting impaired CCC, with an AUC of 0.957.
Conclusions:
- NLR is significantly correlated with impaired CCC development in patients with coronary CTO.
- Elevated NLR may serve as a valuable biomarker for predicting poor collateralization in CTO patients.
- These findings highlight the role of inflammation, as indicated by NLR, in the pathophysiology of coronary collateralization.
Objectives:
To investigate the relationship between neutrophil/lymphocyte ratio (NLR) and coronary collateral circulation (CCC) in patients with coronary chronic total occlusion.
Subjects And Methods:
Our study population consisted of 275 consecutive patients with chronic total occlusion. One hundred and thirty-eight patients with chronic total occlusion were included in the study. They were classified into 2 groups as follows: impaired CCC (group 1: Rentrop grades 0-1) and good CCC (group 2: Rentrop grades 2-3). The NLR was calculated from the complete blood count.
Results:
The NLR values of the patients with impaired CCC (4.5 ± 0.7) were significantly higher than of those with good CCC (2.7 ± 0.6, p < 0.001). In the multivariate logistic regression test, NLR (OR 33.36, 95% CI 8.189-135.7, p < 0.001), high-sensitivity C-reactive protein (hs-CRP; OR 2.152, 95% CI 1.226-3.777, p = 0.008), estimated glomerular filtration rate (OR 1.167, 95% CI 1.049-1.298, p = 0.004) and systolic blood pressure (OR 1.068, 95% CI 1.009-1.1310, p = 0.025) were independent predictors of impaired CCC. The NLR value >3.55 yielded an area under the curve value of 0.957 (95% CI 0.921-0.992, p < 0.001) and demonstrated a sensitivity of 95% and a specificity of 90% for the prediction of CCC. A moderate correlation between NLR and hs-CRP was observed (r = 0.443; p < 0.001).
Conclusion:
Our findings reveal that NLR correlates with the impaired development of coronary collaterals.
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