Işık Turgay, Ayhan Erkan, Uyarel Hüseyin, Tanboğa Ibrahim Halil, Kurt Mustafa, Uluganyan Mahmut, Ergelen Mehmet, Eksik Abdurrahman
Department of Cardiology, Balıkesir University, Faculty of Medicine, Tukey.
Turk Kardiyol Dern Ars. 2013 Mar;41(2):123-30. doi: 10.5543/tkda.2013.17003.
Coronary artery ectasia (CAE) has been defined as a dilated artery luminal diameter that is at least 50% greater than the diameter of the normal portion of the artery. Isolated CAE is defined as CAE without significant coronary artery stenosis and isolated CAE has more pronounced inflammatory symptoms. Neutrophil to lymphocyte ratio (NLR) is widely used as a marker of inflammation and an indicator of cardiovascular outcomes in patients with coronary artery disease. We examined a possible association between NLR and the presence of isolated CAE.
In this study, 2345 patients who underwent coronary angiography for suspected or known ischemic heart disease were evaluated retrospectively. Following the application of exclusion criteria, our study population consisted of 81 CAE patients and 85 age- and gender-matched subjects who proved to have normal coronary angiograms. Baseline neutrophil, lymphocyte and other hematologic indices were measured routinely prior to the coronary angiography.
Patients with angiographic isolated CAE had significantly elevated NLR when compared to the patients with normal coronary artery pathology (3.39 ± 1.36 vs. 2.25 ± 0.58, p<0.001). A NLR level >= 2.37 measured on admission had a 77% sensitivity and 63% specificity in predicting isolated CAE at ROC curve analysis. In the multivariate analysis, hypercholesterolemia (OR=2.63, 95% CI 1.22-5.65, p=0.01), obesity (OR=3.76, 95% CI 1.43-9.87, p=0.007) and increased NLR (OR=6.03, 95% CI 2.61-13.94, p<0.001) were independent predictors for the presence of isolated CAE.
Neutrophil to lymphocyte ratio is a readily available clinical laboratory value that is associated with the presence of isolated CAE.
冠状动脉扩张（CAE）被定义为动脉管腔直径扩张，至少比动脉正常部分的直径大50%。孤立性CAE被定义为无明显冠状动脉狭窄的CAE，且孤立性CAE具有更明显的炎症症状。中性粒细胞与淋巴细胞比值（NLR）被广泛用作炎症标志物和冠心病患者心血管预后的指标。我们研究了NLR与孤立性CAE存在之间的可能关联。
在本研究中，对2345例因疑似或已知缺血性心脏病接受冠状动脉造影的患者进行了回顾性评估。应用排除标准后，我们的研究人群包括81例CAE患者和85例年龄及性别匹配、冠状动脉造影正常的受试者。在冠状动脉造影前常规测量基线中性粒细胞、淋巴细胞和其他血液学指标。
与冠状动脉病理正常的患者相比，血管造影孤立性CAE患者的NLR显著升高（3.39±1.36 vs. 2.25±0.58，p<0.001）。在ROC曲线分析中，入院时测得的NLR水平≥2.37对孤立性CAE的预测敏感性为77%，特异性为63%。在多变量分析中，高胆固醇血症（OR=2.63，95%CI 1.22 - 5.65，p=0.01）、肥胖（OR=3.76，95%CI 1.43 - 9.87，p=0.007）和NLR升高（OR=6.03，95%CI 2.61 - 13.94，p<0.001）是孤立性CAE存在的独立预测因素。
中性粒细胞与淋巴细胞比值是一种易于获得的临床实验室值，与孤立性CAE的存在相关。
