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Relationship Between Inflammatory Readings and the Degree of Coronary Atherosclerosis (Pilot Study)
Agnė Liuizė Abramavičiūtė1, Aušra Mongirdienė1, Jolanta Laukaitienė1
1Department of Biochemistry, Lithuanian University of Health Sciences, LT 44307 Kaunas, Lithuania.
Insights
Novel blood count markers like Neutrophil-to-Lymphocyte Ratio (NLR) and Systemic Immune-Inflammation Index (SIRI) correlate with Coronary Artery Disease (CAD) severity. SIRI shows the strongest association, suggesting its potential in predicting atherosclerosis progression.
Area of Science:
- Cardiology
- Hematology
- Inflammation Research
Background:
- Coronary Artery Disease (CAD) management can benefit from novel prognostic markers.
- Calculated total blood count readings, including Neutrophil-to-Lymphocyte Ratio (NLR), Monocyte-to-Lymphocyte Ratio (MLR), Platelet-to-Lymphocyte Ratio (PLR), Neutrophil-to-Monocyte Ratio (NMR), Lymphocyte-to-Monocyte Ratio (LMR), Monocyte-to-High-density Lipoprotein Ratio (MHR), Systemic Immune-Inflammation Index (SII), and Systemic Immune-Inflammation Ratio (SIRI), are explored.
- The study investigates the association between these markers and CAD severity in patients with Stable Angina Pectoris (SAP).
Purpose of the Study:
- To evaluate the association between various blood count-derived inflammatory markers and the severity of Coronary Artery Disease (CAD) in patients with Stable Angina Pectoris (SAP).
- To identify potential novel biomarkers for assessing clinical management and prognosis in CAD patients.
Main Methods:
- A retrospective pilot study involving 166 patients undergoing Coronary Angiography (CA) or Coronary Computed Tomography Angiography (CCTA).
- Patients were stratified based on the presence or absence of CAD, and by severity using Gensini and CAD-RADS scores.
- Analysis focused on correlations between NLR, MLR, PLR, NMR, LMR, MHR, SII, and SIRI with CAD severity.
Main Results:
- Patients with CAD exhibited lower LMR and higher NLR, SIRI, MLR, and SII compared to those without CAD.
- NLR, MLR, SII, and SIRI values increased, while LMR decreased, progressively with increasing CAD severity (Gensini score).
- Moderate correlations were observed between CAD severity and SII, NLR, and SIRI. MLR and LMR showed low correlations. CAD-RADS scores correlated weakly with NLR and MHR, and moderately with LMR, MLR, and SIRI.
Conclusions:
- NLR, LMR, and SIRI are potential indicators of chronic inflammation in CAD patients.
- SIRI emerged as the most significant predictor of atherosclerosis severity among the evaluated blood parameters.
- These inflammatory markers may offer valuable insights for personalized CAD patient management and prognosis.
Abstract:
Background/Objectives: Some calculated total blood count readings are investigated as novel additional readings to help with evaluation of personalized CAD patients' clinical management and prognosis. We aimed to investigate the association between readings such as NLR, MLR, PLR, NMR, LMR, MHR, SII, and SIRI and the severity of CAD in patients with SAP. Methods: This retrospective pilot study included 166 patients. All patients underwent CA or CCTA, or both, to assess severity of CAD. Patients were divided three ways: (1) according to presence (n = 146) or absence (n = 20) of CAD; (2) according to Gensini score; (3) according to the CAD-RADS score. Results: Patients with CAD had lower LMR, higher NLR, SIRI, MLR, and SII compared to patients without CAD (p < 0.001 and p = 0.018, respectively for SII). According to the CAD severity by Gensini score, the NLR, MLR, SII, and SIRI values increase and LMR decreases gradually with severity of CAD (p < 0.001). A moderate correlation was found between SII (r = 0.511, p < 0.001), NLR (r = 0.567, p < 0.001), and SIRI (r = 0.474, p < 0.001) and severity of CAD according to Gensini score. MLR and LMR had a low corelation with severity of CAD according to Gensini score (r = 0.356, p < 0.001; r = -0.355, p < 0.001, respectively). The CAD-RADS score weakly correlated with NLR and MHR (r = 0.365, p < 0.001; r = 0.346, p < 0.001, respectively), and moderately with LMR, MLR, and SIRI (r = -0.454, p < 0.001; r = 0.455, p < 0.001; r = 0.522, p < 0.001, respectively). Conclusions: NLR, LMR, and SIRI appear to be potential predictors of chronic inflammation, and SIRI is the best predictor of the degree of atherosclerosis of all the other assessed blood parameters.
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