Relationship between neutrophils to HDL-C ratio and severity of coronary stenosis
Tuli Kou1, Haorou Luo2, Lixue Yin3,4
1Southwest Medical University, Luzhou, China.
Insights
The neutrophil to HDL-C ratio effectively predicts coronary artery disease (CAD) severity. This novel biomarker integrates inflammation and atherosclerosis markers, offering a new tool for assessing coronary stenosis.
Area of Science:
- Cardiology
- Biomarkers
- Inflammation Research
Background:
- Lipid and inflammatory molecules are crucial in inflammation development.
- Neutrophil count indicates inflammation duration, while HDL-C is an anti-atherosclerosis marker.
- Few studies integrate these markers for coronary stenosis.
Purpose of the Study:
- To integrate neutrophil count and HDL-C into a single biomarker, the neutrophil-to-HDL-C ratio (NHR).
- To explore the correlation of NHR with coronary artery disease (CAD) degree.
- To predict the severity of coronary stenosis in CAD patients.
Main Methods:
- Examined 404 patients undergoing coronary angiography.
- Categorized patients into CAD+ (>=50% stenosis), CAD- (<=50% stenosis), and control groups.
- Utilized Spearman correlation and logistic regression to analyze serum markers and stenosis severity.
Main Results:
- The neutrophil-to-HDL-C ratio positively correlated with the modified Gensini score.
- NHR was significantly associated with CAD and identified as an independent predictor.
- ROC analysis yielded a cut-off value of 1.51 for NHR to predict CAD with high sensitivity.
Conclusions:
- The neutrophil-to-HDL-C ratio is closely related to coronary artery stenosis.
- NHR serves as an independent predictor of severe coronary stenosis.
- This ratio offers a novel approach to assessing CAD severity.
Background:
Lipid and inflammatory molecules play a key role in the development of inflammation. Neutrophil counts are used as markers of inflammation duration, and HDL-C is used as an anti-atherosclerosis component. However, few studies have been found to integrate these two indicators to explore coronary stenosis. We suggested that neutrophil count as a marker of inflammation persistence and HDL-C as an anti-atherosclerotic component should be integrated into a single biomarker NHR to explore its correlation with CAD degree and predict the severity of coronary stenosis among CAD patients.
Methods:
We examined 404 eligible patients who underwent coronary angiography. Based on the results of coronary angiography, patients in CAD+ group (n = 155) were defined as those having angiographic coronary stenosis of at least 50% lumen reduction in at least one major coronary artery (including left anterior descending artery, left circumflex artery, left main coronary artery, right coronary artery). Patients with luminal stenosis but no more than 50% were defined as CAD- group (n = 49), and patients without luminal stenosis (n = 200) were regarded as control group. The relationship between various serum markers and the severity of coronary stenosis was examined by Spearman correlation analysis. Logistic regression analysis was performed to identify the influencing factors of the severity of coronary artery disease.
Results:
The modified Gensini score was positively correlated with neutrophil HDL-C ratio and negatively correlated with albumin and HDL-C. Multiple regression analysis showed that neutrophil HDL-C ratio were significantly associated with CAD. Neutrophil HDL-C ratio is an independent predictor of CAD. The ROC analysis provided a cut-off value of 1.51 for neutrophil HDL-C ratio to predict CAD with 94.8% sensitivity and 0.024 Yoden index, and area under the ROC curve of 0.617 (95% CI 0.560-0.675, P < 0.001).
Conclusion:
Neutrophil HDL-C ratio is not only closely related to coronary artery stenosis, but also an independent predictor of severe coronary stenosis.
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