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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Association between Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios and Coronary Artery Calcification Score
Carlos V Serrano1, Fernando R de Mattos1,2, Fábio G Pitta1,2
1Heart Institute (InCor), Medical School, University of Sao Paulo, Brazil.
Insights
The neutrophil-lymphocyte ratio (NLR) can help predict coronary artery calcification (CAC) in asymptomatic individuals. Higher NLR levels are associated with more severe CAC, offering an additional tool for risk stratification.
Area of Science:
- Cardiology
- Inflammation Markers
- Medical Diagnostics
Background:
- Atherosclerosis is a chronic inflammatory condition.
- Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are inflammation markers.
- Their association with coronary calcification in asymptomatic individuals requires further investigation.
Purpose of the Study:
- To investigate the relationship between NLR, PLR, and coronary atherosclerotic calcification (CAC) in asymptomatic patients.
- To determine if these ratios can aid in risk stratification for coronary artery disease (CAD).
Main Methods:
- Retrospective analysis of clinical and laboratory data from 247 asymptomatic patients.
- Coronary artery calcium (CAC) scoring using computed tomography.
- Evaluation of risk factors, NLR, and PLR across different CAC score categories.
- Statistical analysis including chi-square, linear, and logistic regression.
Main Results:
- Older age and higher NLR were independently associated with CAC scores greater than 100.
- Diabetes and higher LDL cholesterol levels were more prevalent in groups with higher CAC scores.
- PLR did not show a significant association with CAC severity.
Conclusions:
- NLR serves as an independent predictor of coronary artery calcification extent in asymptomatic patients.
- NLR can enhance risk stratification for CAD in this population.
- PLR is not a reliable marker for assessing CAD severity in asymptomatic individuals.
Introduction:
Atherosclerosis is a low-grade inflammatory disease. Among markers of inflammation, importance has been given to the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR). The objective of this study was to examine the association between these hematological indices of inflammation and coronary atherosclerotic calcification in clinically asymptomatic patients.
Methods:
This study had clinical and laboratorial data collected from consecutive asymptomatic patients that underwent computed tomography coronary artery calcium (CAC) scoring. Risk factors, NLR, and PLR were evaluated at different categories of CAC scoring. Statistical tests included chi-square, linear regression, and logistic regression. Patients (N = 247; age 60.4 ± 8.0 years and 60.7% men) were allocated into four categories according to the CAC score.
Results:
Respective age, sex (male), NLR, and PLR distribution within groups were as follows: CAC = 0 (n = 98; 52.5 ± 13.6 years, 55%, 2.0 ± 1.0, and 121.5 ± 41.5), CAC 1-100 (N = 64; 61.3 ± 11.0 years, 60%, 2.2 ± 1.2, and 125.6 ± 45.6), CAC 101-400 (N = 37; 64.2 ± 11.6 years, 67%, 2.6 ± 1.3, and 125.4 ± 55.9), and CAC > 400 (N = 48; 69.3 ± 11.1 years, 66%, 3.3 ± 2.0, and 430.1 ± 1787.4). The association between risk factors and CAC score was assessed. Hypertension status and smoking status were similar within groups, while the presence of diabetes (P = 0.02) and older age (P ≤ 0.001) was more prevalent in the CAC > 400 group. LDL cholesterol was greater in the higher CAC score groups (P = 0.002). Multivariate logistic regression of the quartile analysis showed that age and NLR were independently associated with CAC > 100 (OR (CI), P value): 2.06 (1.55-2.73, P = 0.00001) and 1.82 (1.33-2.49, P = 0.0002), respectively.
Conclusion:
Within asymptomatic patients, NLR provides additional risk stratification, as an independent association between NLR extent and CAD extent was identified. Moreover, PLR was not an inflammation marker for CAD severity.
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