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Combination of change in hematological parameters with exercise stress test to predict coronary artery disease

Ahmet Korkmaz1, Abdulkadir Yıldız2, Pınar Türker Duyuler1

  • 1Cardiology Clinic, Ankara Numune Training Hospital, Ankara, Turkey.

Journal of Clinical Laboratory Analysis
|March 21, 2017
PubMed

Insights

The neutrophil to lymphocyte ratio (NLR) increases after treadmill exercise tests. A higher increase in NLR can help predict coronary artery disease (CAD) with high accuracy when combined with exercise testing.

Area of Science:

  • Cardiology
  • Hematology
  • Exercise Physiology

Background:

  • Current guidelines recommend treadmill exercise stress testing for identifying coronary artery disease (CAD) risk.
  • Evaluating hematological changes post-exercise may offer additional diagnostic insights.

Purpose of the Study:

  • To assess changes in hematological parameters, specifically neutrophil count and neutrophil-to-lymphocyte ratio (NLR), before and after treadmill exercise testing.
  • To correlate these hematological changes with the presence and severity of CAD.

Main Methods:

  • 113 patients with chest pain underwent treadmill exercise testing and coronary angiography.
  • Neutrophil counts and NLR were measured pre- and post-exercise.
  • Changes in NLR were analyzed in relation to exercise test results and angiographic findings.

Main Results:

  • Neutrophil count and NLR significantly increased after exercise in all patients (P<.001).
  • The increase in NLR post-exercise was significantly greater in patients with a positive exercise test (P=.016).
  • Combining a positive treadmill test with a change in NLR cutoff of 0.2 achieved 91% sensitivity and 92% specificity for predicting significant coronary artery stenosis.

Conclusions:

  • Neutrophil-to-lymphocyte ratio (NLR) serves as a valuable inflammatory marker.
  • NLR changes following exercise testing can augment the diagnostic capability of treadmill ECG for CAD detection.
  • This approach enhances the prediction of significant coronary artery stenosis.
Abstract

Keywords:
coronary artery diseaseexercise stress testneutrophil countneutrophil to lymphocyte ratio

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