Sönmez Osman, Ertaş Gökhan, Bacaksız Ahmet, Tasal Abdurrahman, Erdoğan Ercan, Asoğlu Emin, Uyarel Hüseyin, Göktekin Omer
Department of Cardiology, Faculty of Medicine, Bezmi Alem Vakıf University, İstanbul-Turkey.
Anadolu Kardiyol Derg. 2013 Nov;13(7):662-7. doi: 10.5152/akd.2013.188. Epub 2013 Jul 31.
The neutrophil -to- lymphocyte ratio (NLR) is a new predictor for cardiovascular risk and mortality. The SYNTAX score is an angiographic tool used in grading the complexity of coronary artery disease (CAD). However, its relation with CAD severity and complexity is not yet known. We hypothesized that NLR would be associated with a greater complexity of CAD as assessed using the SYNTAX score.
This cross-sectional observational study included 106 patients who had undergone coronary angiography for stable angina pectoris and 69 patients who had normal coronary angiogram. Baseline NLR was measured by dividing neutrophil count to lymphocyte count. The patients were classified two groups as CAD (-) (n=69) and CAD (+) (n=106), then patients in CAD (+) group were divided into 3 groups according to SYNTAX scores (SYNTAX score 1-22, 23-32, >32) as pointed in European Society of Cardiology (ESC) revascularization guideline. Statistical analysis was performed using the Mann-Whitney U and Kruskal-Wallis tests, and multiple logistic regression analysis was used to identify the independent predictors of complexity of CAD-SYNTAX score.
Patients with CAD had a significantly higher value of NLR [1.6 median (1.2-3.3 IQR) vs. 2.3 median (1.8-3.0 IQR) p<0.001]. The group with high SYNTAX scores (>32) more frequently had diabetes mellitus (DM), hypercholesterolemia (HL), were of older age, and also had significantly elevated NLR values [2.4 (1.3-2.6), 2.6 (2.3-3.9), 2.0 (1.5-2.6) p=0.006]. In univariate analysis, age, DM, HL, creatinine, neutrophil count and NLR were predictors of high SYNTAX score. In the multiple logistic regression analysis, only NLR [odds ratio (OR)=2.1, 95% confidence interval (CI) 1.2-3.8, p=0.09], was identified as independent predictor of a high SYNTAX score.
NLR is a strong clinical laboratory value that is associated with presence and complexity of CAD.
中性粒细胞与淋巴细胞比值（NLR）是心血管风险和死亡率的一种新的预测指标。SYNTAX评分是一种用于评估冠状动脉疾病（CAD）复杂性的血管造影工具。然而，其与CAD严重程度和复杂性的关系尚不清楚。我们假设，使用SYNTAX评分评估时，NLR将与更高的CAD复杂性相关。
这项横断面观察性研究纳入了106例因稳定型心绞痛接受冠状动脉造影的患者和69例冠状动脉造影正常的患者。通过将中性粒细胞计数除以淋巴细胞计数来测量基线NLR。患者被分为CAD（-）组（n = 69）和CAD（+）组（n = 106），然后根据欧洲心脏病学会（ESC）血运重建指南中指出的SYNTAX评分（SYNTAX评分1 - 22、23 - 32、> 32）将CAD（+）组患者分为3组。使用Mann - Whitney U检验和Kruskal - Wallis检验进行统计分析，并使用多元逻辑回归分析来确定CAD - SYNTAX评分复杂性的独立预测因素。
CAD患者的NLR值显著更高[中位数1.6（四分位间距1.2 - 3.3）对中位数2.3（四分位间距1.8 - 3.0），p < 0.001]。SYNTAX评分高（> 32）的组更常患有糖尿病（DM）、高胆固醇血症（HL），年龄更大，且NLR值也显著升高[2.4（1.3 - 2.6）、2.6（2.3 - 3.9）、2.0（1.5 - 2.6），p = 0.006]。在单因素分析中，年龄、DM、HL、肌酐、中性粒细胞计数和NLR是高SYNTAX评分的预测因素。在多元逻辑回归分析中，只有NLR[比值比（OR）= 2.1，95%置信区间（CI）1.2 - 3.8，p = 0.09]被确定为高SYNTAX评分的独立预测因素。
NLR是一个强有力的临床实验室指标，与CAD的存在和复杂性相关。
