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NEUTROPHIL-LYMPHOCYTE RATIO AND PLATELET-LYMPHOCYTE RATIO AS PREDICTORS OF CORONARY MICROCIRCULATORY DISEASE
Piotr Szolc1, Łukasz Niewiara1, Marta Kawulak1
1DEPARTMENT OF INTERVENTIONAL CARDIOLOGY, JAGIELLONIAN UNIVERSITY MEDICAL COLLEGE, INSTITUTE OF CARDIOLOGY, JOHN PAUL II HOSPITAL, CRACOW, POLAND.
Insights
Higher neutrophil-lymphocyte ratio and platelet-lymphocyte ratio indicate coronary microcirculatory disease. Elevated platelet-lymphocyte ratio predicts worse outcomes in these patients, highlighting its prognostic value.
Area of Science:
- Cardiology
- Vascular Biology
- Inflammation Markers
Background:
- Coronary microcirculatory dysfunction is linked to adverse cardiovascular events.
- Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are emerging inflammatory markers.
- Assessing coronary microcirculation function is typically invasive.
Purpose of the Study:
- To evaluate NLR and PLR levels in patients with coronary microcirculatory disease (CMD).
- To investigate the association between NLR, PLR, and clinical outcomes in CMD patients.
- To determine the predictive value of NLR and PLR for CMD and prognosis.
Main Methods:
- 82 patients with suspected CMD underwent index of microcirculatory resistance (IMR) assessment.
- NLR and PLR were calculated from admission blood counts.
- Patients were followed for major adverse cardiac and cardiovascular events (MACCE) for a median of 24 months.
Main Results:
- Patients with CMD exhibited significantly higher NLR and PLR compared to controls.
- Higher PLR levels correlated with worse MACCE-free survival.
- Optimal cut-off values for detecting CMD were identified as NLR 3.2 and PLR 181.3.
Conclusions:
- Elevated NLR and PLR are associated with increased IMR, indicating CMD.
- PLR serves as a potential predictor of adverse clinical outcomes in patients with CMD.
Objective:
Introduction: Index of microcirculatory resistance assessment is an invasive method of measuring coronary microcirculation function. Association between impaired microcirculatory function and higher rate of cardiovascular events was proven. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio seem to be a promising parameters to predict coronary microcirculatory disease in patients with chronic coronary syndrome. The aim: To determine neutrophil-lymphocyte ratio and platelet-lymphocyte ratio levels in patients with coronary microcirculatory disease and potential association with clinical outcome.
Patients And Methods:
Material and methods: 82 consecutive patients with mean age of 67 years, 67% male, were tested for presence of coronary microcirculatory disease using index of microcirculatory resistance. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio were calculated based on admission full blood count. Follow-up with major adverse cardiac and cardiovascular events registration was performed (median 24 months).
Results:
Results: The study showed significantly higher neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in patients with coronary microcirculatory disease compared to control group (3.58±2.61 vs 2.54±1.09 and 164±87.9 vs 124±36.6 respectively). Higher level of platelet-lymphocyte ratio in patients with coronary microcirculatory disease results in worse MACCE-free survival. Optimal cut-off values of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio to detect coronary microcirculatory disease were 3.2 and 181.3, respectively.
Conclusion:
Conclusions: Higher neutrophil-lymphocyte ratio and platelet-lymphocyte ratio are associated with increased index of microcirculatory resistance value. Platelet-lymphocyte ratio may be used as a predictor of worse outcome in patients with coronary microcirculatory disease.
