Ahmad Nadeem, Raza Muhammad Tahir, Ali Muhammad Ammar, Tahir Urooj, Ibrahim Hamza, Iqbal Ahmad S, Ali Rana Shahzaib, Tariq Muhammad Arslan, Majeed Saqib, Hassan Muhammad, Liaquat Sana, Khan Tayyab Mumtaz
Cardiology, Allama Iqbal Medical College, Lahore, PAK.
Cardiology, Rawalpindi Medical University, Rawalpindi, PAK.
Cureus. 2024 Sep 10;16(9):e69061. doi: 10.7759/cureus.69061. eCollection 2024 Sep.
Background Coronary artery disease (CAD) is one of the major causes of death all over the world. Its severity evaluation through the Gensini scoring system is quite a complex process as these score systems require complex investigations and cardiologists. Therefore, this study aimed to determine the predictive capacity of neutrophil-to-lymphocyte ratio (NLR) for the severity of CAD in patients with myocardial infarction. Methods This cross-sectional study was performed on 208 patients with acute myocardial infarction whose coronary angiography was performed in the Department of Cardiology of Benazir Bhutto Hospital (BBH), Rawalpindi, Pakistan during the period of one year from January 2022 to March 2023. The enrollment of patients was made through purposive sampling and established inclusion and exclusion criteria. Ethical approval and informed consent were acquired before the data collection. Data was collected through a self-structured form. Vessel score and Gensini score were applied for the assessment of the severity of CAD. Patients were divided into two groups based on the Gensini score system. Data analysis was carried out in the Statistical Package for the Social Sciences (SPSS) version 25 (Released 2017; IBM Corp., Armonk, New York, United States). Both descriptive and inferential statistics were used to compare the study variables between the patients with non-severe CAD and patients with severe CAD. Pearson's correlation was used to determine the correlation between the NLR and the severity of CAD. A linear regression model was applied to evaluate the predictive capacity of the NLR for the severity of CAD. A p-value less than 0.05 was set as statistically significant. Results Out of 208 patients, 128 (61.53%) patients had non-severe CAD while 80 (38.47%) patients had severe CAD. Significant differences were observed in the Gensini mean scores, NLR values, and in the frequencies of hypertension, diabetes mellitus, dyslipidemia, and history of smoking, with p≤0.05 for all these variables, between the non-severe CAD group and severe CAD group. NLR was significantly correlated with the severity of CAD (p-value=0.001). Pearson's correlation coefficient was 0.71 for NLR with the Gensini scores. The simple linear regression model was valid (the p-value of the F test was <0.000), with beta coefficients of 2.60 (p=0.002) for NLR. The R value was 0.80 (80%). Conclusions In the current study, a significant percentage of patients had severe CAD. Furthermore, a positive and significant association was noted between the NLR with the severity of CAD. This present study suggests that NLR is a reliable predictor of CAD severity; therefore, it could be used for risk stratification of cardiac patients with CAD.
背景 冠状动脉疾病（CAD）是全球主要的死亡原因之一。通过Gensini评分系统评估其严重程度是一个相当复杂的过程，因为这些评分系统需要复杂的检查和心脏病专家。因此，本研究旨在确定中性粒细胞与淋巴细胞比值（NLR）对心肌梗死患者CAD严重程度的预测能力。
方法 本横断面研究对208例急性心肌梗死患者进行，这些患者于2022年1月至2023年3月期间在巴基斯坦拉瓦尔品第贝娜齐尔·布托医院（BBH）心内科进行了冠状动脉造影。通过目的抽样和既定的纳入及排除标准纳入患者。在数据收集前获得了伦理批准和知情同意。通过自行设计的表格收集数据。应用血管评分和Gensini评分评估CAD的严重程度。根据Gensini评分系统将患者分为两组。在社会科学统计软件包（SPSS）25版（2017年发布；美国纽约州阿蒙克IBM公司）中进行数据分析。使用描述性和推断性统计来比较非重度CAD患者和重度CAD患者之间的研究变量。采用Pearson相关性分析确定NLR与CAD严重程度之间的相关性。应用线性回归模型评估NLR对CAD严重程度的预测能力。将p值小于0.05设定为具有统计学意义。
结果 在208例患者中，128例（61.53%）患者患有非重度CAD，而80例（38.47%）患者患有重度CAD。在非重度CAD组和重度CAD组之间，观察到Gensini平均评分、NLR值以及高血压、糖尿病、血脂异常和吸烟史的频率存在显著差异，所有这些变量的p值均≤0.05。NLR与CAD严重程度显著相关（p值 = 0.001）。NLR与Gensini评分的Pearson相关系数为0.71。简单线性回归模型有效（F检验的p值 < 0.000），NLR的β系数为2.60（p = 0.002）。R值为0.80（80%）。
结论 在本研究中，相当比例的患者患有重度CAD。此外，NLR与CAD严重程度之间存在显著的正相关。本研究表明，NLR是CAD严重程度可靠的预测指标；因此，它可用于CAD心脏病患者的风险分层。
