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The Relationship Between Neutrophil/Lymphocyte Ratio Before Coronary Angiography and Coronary Collateral Development
Sefa Sural1, Tarkan Tekten2, Hasan Gungor2
1Cardiology, Istinye University, Istanbul, TUR.
Insights
Higher neutrophil-to-lymphocyte ratio (NLR) is linked to better coronary collateral (CC) development in patients with coronary artery disease. This finding suggests NLR may predict good CC filling, aiding in risk assessment.
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.
Objective:
The aim of this study was to determine the relationship between the neutrophil/lymphocyte ratio (NLR) measured before coronary angiography and coronary collateral (CC) development.
Method:
This retrospective descriptive study was carried out between January 2012 and June 2013 in the cardiology outpatient clinic of a university hospital in Aydın, with 165 patients who were diagnosed with acute coronary syndrome or stable angina pectoris and who had 95% or more stenosis in at least one coronary artery according to angiography. Coronary artery stenosis was determined by Gensini scoring. The classification of CC was performed by the Rentrop method, and patients were divided into two groups: Rentrop stages 0 and 1 (poor CC filling (group 1)) and Rentrop stages 2 and 3 (good CC filling (group 2)). The data were analyzed using appropriate statistical analyses. Multivariate logistic regression was used to determine the predictors of CC level, and receiver operating characteristic (ROC) curve analysis was performed to calculate the predictive value of predictors.
Results:
When the groups were compared, the mean age (p=0.023), Gensini score (p<0.001), smoking status (p=0.012), creatinine level (p=0.032), and aspartate aminotransferase level (p=0.032) of the patients in group 1 were significantly lower than those in group 2, while their total cholesterol (p=0.006) and low-density lipoprotein (LDL) levels (p=0.020) were higher. Neutrophils (p=0.016) and NLR (p<0.001) were significantly higher in group 2 patients. A significant positive correlation was found between CC level and neutrophils (p=0.035) and NLR (p=0.011). In regression analysis, high NLR, high Gensini score, and smoking were predictors of good CC filling. According to ROC curve analysis, the sensitivity and specificity of NLR ≥3.53 at the time of presentation to the clinic for predicting good CC filling were 37.6% and 85%, respectively.
Conclusion:
This study showed that NLR was significantly associated with the development of good CC filling; as NLR increased, the development of good CC filling increased in patients.
