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Predictive value of lymphocyte to monocyte ratio for cardiac syndrome X
Insights
Lower LMR levels are associated with Cardiac Syndrome X (CSX), a condition characterized by chest pain and ischemia without coronary artery blockages. This finding suggests LMR may help predict CSX.
Area of Science:
- Cardiology
- Biomarkers
- Inflammation
Background:
- Cardiac Syndrome X (CSX) presents as angina-like chest pain with evidence of ischemia but no obstructive coronary artery disease.
- The diagnostic criteria for CSX include specific stress test findings or myocardial perfusion scintigraphy results alongside normal coronary angiography.
- Identifying reliable biomarkers for CSX is crucial for improved diagnosis and management.
Purpose of the Study:
- To investigate the relationship between the monocyte-to-lymphocyte ratio (LMR) and the presence of Cardiac Syndrome X.
- To determine if LMR can serve as a predictor for CSX.
Main Methods:
- A retrospective study included 116 patients diagnosed with CSX and 153 control subjects.
- Patient data, including LMR and C-reactive protein (CRP) levels, were analyzed.
- Statistical analyses included Pearson correlation and multivariate logistic regression, with Receiver Operating Characteristic (ROC) curve analysis for diagnostic accuracy.
Main Results:
- Patients with CSX exhibited higher monocyte counts and LMR compared to controls.
- A negative correlation was observed between CRP levels and LMR.
- LMR was identified as a significant independent predictor of CSX in multivariate analysis.
- An LMR threshold of < 4.1 demonstrated 64% sensitivity and 50% specificity for predicting CSX.
Conclusions:
- Lower LMR levels are significantly associated with the presence of Cardiac Syndrome X.
- LMR may serve as a valuable biomarker for predicting CSX in clinical practice.
Objective:
Cardiac syndrome X (CSX) is typically described with ischemia in stress tests in addition to angina-like chest pain and without stenosis in coronary angiography. We aimed at determining the relationship between LMR and CSX.
Patients And Methods:
We retrospectively collected patients with CSX between January 2016 and December 2019. Patients with typical angina-like chest pain, normal 12-lead electrocardiography at rest, a positive response to the exercise test (> 0.1 mV ST-segment depression at 80 ms after the J point in two or more contiguous leads) or ischemia on myocardial perfusion scintigraphy and normal coronary angiography were included in the study as CSX patients.
Results:
This study consisted of 116 patients with CSX and 153 control groups. The mean age of the patients with CSX was 52.7±9.7 years, and the mean age of the control group was 53.7±10.6 years (p= 0.416). The patients with CSX were more likely to have higher monocyte counts and LMR. According to the Pearson correlation test, the CRP value negatively correlated with the LMR. In multivariate logistic regression analysis, LMR remained a significant predictor of CSX. In ROC analysis, LMR < 4.1 had 64% sensitivity and 50% specificity (ROC area under curve: 0.587, 95% CI: 0.519-0.655, p=0.015) in accurately predicting a CSX diagnosis.
Conclusions:
We showed that lower LMR levels were associated with the presence of CSX.
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