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Association of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios With Three-Vessel Coronary Artery Disease:

Ladan Ayazkhoo1, Mohammad Sistanizad1,2, Mohammad Haji Aghajani2

  • 1Department of Clinical Pharmacy, School of Pharmacy Shahid Beheshti University of Medical Sciences Tehran Iran.

Health Science Reports
|April 30, 2026
PubMed

Insights

The neutrophil-to-lymphocyte ratio (NLR) is a significant predictor of severe coronary artery disease (CAD), offering a cost-effective method for risk stratification. While the platelet-to-lymphocyte ratio (PLR) shows association, further research is needed.

Area of Science:

  • Cardiology
  • Inflammation research
  • Biomarker discovery

Background:

  • Coronary artery disease (CAD) is a major global cause of mortality.
  • Inflammation is a key factor in CAD development.
  • Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are emerging inflammatory biomarkers for CAD.

Purpose of the Study:

  • To investigate the association between NLR, PLR, and the severity of CAD, specifically three-vessel disease.
  • To evaluate the predictive value of NLR and PLR in patients undergoing coronary angiography.

Main Methods:

  • A registry-based case-control study involving 300 patients.
  • Patients were categorized into two groups: those with three-vessel CAD (≥50% stenosis) and those with normal coronary arteries.
  • Logistic regression analyses were used to determine the predictive value of NLR and PLR.

Main Results:

  • Patients with three-vessel CAD exhibited significantly higher NLR (≥2.5) and PLR (≥130) compared to controls (p<0.05).
  • An NLR of ≥2.5 was independently associated with a 91% increased odds of three-vessel CAD (OR=1.91, p=0.037).
  • Elevated PLR showed a trend towards association with three-vessel CAD but did not reach statistical significance after adjustment (OR=1.79, p=0.077).

Conclusions:

  • NLR is a significant predictor of severe CAD and a potentially cost-effective biomarker for risk stratification.
  • PLR may be associated with CAD severity, but requires further investigation.
  • Additional inflammatory markers should be explored to improve CAD risk assessment.
Abstract

Keywords:
biomarkerscoronary artery diseaseinflammationneutrophil‐to‐lymphocyte ratioplatelet‐to‐lymphocyte ratiorisk stratification

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