Neutrophil-to-lymphocyte ratio predicts functionally significant coronary artery stenosis in patients with stable coronary artery disease
Samet Yılmaz, Uğur Canpolat1, Kazım Başer
1Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey. dru_canpolat@yahoo.com.
Insights
The neutrophil-to-lymphocyte ratio (NLR) is higher in patients with significant coronary artery stenosis. This simple blood test can help predict the severity of blocked arteries in stable coronary artery disease (CAD).
Area of Science:
- Cardiology
- Biomarkers
- Inflammation
Background:
- Stable coronary artery disease (CAD) affects millions globally.
- Assessing the functional significance of coronary stenosis is crucial for guiding treatment decisions.
- Fractional flow reserve (FFR) is a gold standard for evaluating lesion severity, but it is invasive.
Purpose of the Study:
- To investigate the relationship between the neutrophil-to-lymphocyte ratio (NLR) and the functional severity of coronary stenosis.
- To determine if NLR can serve as a non-invasive predictor of significant coronary artery stenosis in patients with stable CAD.
Main Methods:
- Retrospective analysis of clinical and laboratory data from 420 patients with stable angina pectoris.
- Coronary angiography was performed, and functional severity of intermediate lesions was assessed using FFR.
- Patients were divided into two groups: non-significant stenosis (FFR >0.80) and significant stenosis (FFR ≤0.80).
Main Results:
- 137 patients (32.6%) had functionally significant coronary stenosis.
- Median NLR was significantly higher in patients with significant stenosis compared to those without (3.13 vs 2.22, p<0.001).
- NLR, along with Gensini score, diabetes, and smoking, independently predicted significant coronary stenosis (OR: 1.62, p<0.001). An NLR cutoff of 2.3 showed 72% sensitivity and 61% specificity.
Conclusions:
- Pre-angiographic NLR is a simple, non-invasive, and inexpensive biomarker.
- Elevated NLR is associated with functionally significant coronary stenosis in stable CAD patients.
- NLR can aid in predicting the hemodynamic severity of intermediate coronary stenosis.
Objective:
The aim of this study was to determine the relationship between the neutrophil-to-lymphocyte ratio (NLR) and the functional severity of coronary stenosis assessed according to the fractional flow reserve (FFR) in stable coronary artery disease (CAD).
Methods:
The clinical and laboratory data of 420 patients who underwent index coronary angiography for stable angina pectoris were analyzed retrospectively. The functional severity of an intermediate lesion was determined by FFR. An FFR value of >0.80 was considered non-significant (Group 1), whereas ≤0.80 was accepted as significant stenosis (Group 2).
Results:
A total of 137 (32.6%) patients had functionally significant coronary artery stenosis. The median NLR value was significantly greater in Group 2 compared with Group 1 [3.13 (0.93-9.75) vs 2.22 (0.75-6.02); p<0.001]. In multivariable logistic regression analysis, the Gensini score [odds ratio (OR): 1.04; 95% confidence interval (CI): 1.02-1.06; p<0.001], diabetes mellitus (OR: 2.56; 95% CI: 1.38-4.75; p=0.003), smoking (OR: 2.09; 95% CI: 1.12-3.94; p=0.021), and NLR (OR: 1.62; 95% CI:1.26-2.09; p<0.001) were found to be independent predictors of the presence of functionally significant coronary stenosis using an FFR value of ≤0.80. The optimal cut-off value of NLR for predicting functionally significant coronary stenosis was 2.3. An NLR value greater than 2.3 had a sensitivity of 72% and a specificity of 61% to predict stenosis with an FFR value of ≤0.80.
Conclusion:
The pre-angiographic NLR is a simple, noninvasive, and inexpensive biomarker that was significantly higher in patients with functionally significant coronary stenosis; it can be used to predict the hemodynamic severity of intermediate coronary stenosis in patients with stable CAD.
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