The Relationship Between Neutrophil/Lymphocyte Ratio Before Coronary Angiography and Coronary Collateral Development

Area of Science:

• Cardiology
• Hematology
• Biomarkers

Background:

• Coronary artery disease (CAD) is a leading cause of mortality worldwide.
• Coronary collateral (CC) circulation plays a crucial role in mitigating ischemic damage in CAD.
• Predictive markers for CC development are essential for patient management.

Purpose of the Study:

• To investigate the relationship between pre-angiography neutrophil-to-lymphocyte ratio (NLR) and coronary collateral (CC) development.
• To determine if NLR can predict good CC filling in patients with significant coronary artery stenosis.

Main Methods:

• Retrospective analysis of 165 patients with acute coronary syndrome or stable angina pectoris.
• Coronary artery stenosis assessed by Gensini score and CC by Rentrop method.
• Patients categorized into poor (Rentrop 0-1) and good (Rentrop 2-3) CC filling groups.
• Multivariate logistic regression and ROC curve analysis used to identify predictors of CC level.

Main Results:

• Patients with good CC filling had significantly higher NLR, neutrophils, Gensini score, and LDL levels.
• NLR showed a significant positive correlation with CC level.
• High NLR (≥3.53), high Gensini score, and smoking were identified as predictors of good CC filling.
• ROC analysis indicated NLR ≥3.53 had 37.6% sensitivity and 85% specificity for predicting good CC filling.

Conclusions:

• Neutrophil-to-lymphocyte ratio (NLR) is significantly associated with good coronary collateral (CC) development.
• Elevated NLR levels correlate with enhanced CC formation in patients with coronary artery disease.
• NLR serves as a potential predictive biomarker for good CC development.