低密度脂蛋白胆固醇低于1.4 mmol/L的冠心病患者中性粒细胞与淋巴细胞比值水平与心血管病因及全因死亡率的关系：一项多中心队列研究。

Association between neutrophil-lymphocyte ratio levels and mortality related to cardiovascular cause and all causes in coronary artery disease patients with low-density lipoprotein cholesterol below 1.4 mmol/L: A multicenter cohort study.

作者信息

Jiang Rengui, Ruan Huangtao, Zhang Weipeng, Chen Jinming, Yang Yupeng, Tang Shangyi, Wang Yueting, Ruan Xianlin, Cao Jun, Zhu Hengqing, Xie Nianjin, Liu Yong, Tan Ning

机构信息

Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510515, China; Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China; Department of Cardiology, Ganzhou Hospital of Guangdong Provincial People's Hospital, Ganzhou Municipal Hospital (Gannan Medical University Affiliated Municipal Hospital), Ganzhou, 341000, China.

Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China.

出版信息

Nutr Metab Cardiovasc Dis. 2025 Sep;35(9):104058. doi: 10.1016/j.numecd.2025.104058. Epub 2025 Apr 11.

DOI:10.1016/j.numecd.2025.104058

PMID:40268567

Abstract

BACKGROUND AND AIMS

Neutrophil-lymphocyte ratio (NLR) can reflect the residual risk of patients with coronary atherosclerotic disease (CAD). However, in CAD patients with low density lipoprotein cholesterol (LDL-C) less than 1.4 mmol/L, the relationship between NLR and poor prognosis remains unclear. The purpose of this research is to examine the relationship between NLR and mortality from cardiovascular causes as well as all causes in the study group.

METHODS AND RESULTS

From the beginning of 2007 to the end of 2020, 2749 individuals with LDL-C under 1.4 mmol/L at baseline and CAD diagnosed via coronary angiography were part of this research. The selected population was divided into four groups according to the level of NLR, and Cox regression model was used mainly to evaluate the association between NLR and cardiovascular and all-cause mortality. After a follow-up of median 6 years, a total of 182 cardiovascular deaths and 460 all-cause deaths had occurred. The Cox regression analysis of fully adjusted model showed that an elevated NLR is connected to a higher risk of mortality from cardiovascular cause (HR: 2.18, 95 %CI: 1.38-3.43) and all causes (HR: 1.33, 95 %CI: 1.02-1.74) in the fourth quartile group. Subgroup analysis indicated that younger and middle-aged patients, as well as those with multivessel coronary artery disease, may have a heightened residual risk of inflammation.

CONCLUSION

NLR can be a useful risk factor indicator for cardiovascular and all-cause mortality in CAD patients with LDL-C levels below 1.4 mmol/L, and it also points to residual risk.

摘要

背景与目的

中性粒细胞与淋巴细胞比值（NLR）可反映冠状动脉粥样硬化性心脏病（CAD）患者的残余风险。然而，在低密度脂蛋白胆固醇（LDL-C）低于1.4 mmol/L的CAD患者中，NLR与不良预后之间的关系仍不明确。本研究的目的是探讨研究组中NLR与心血管原因及全因死亡率之间的关系。

方法与结果

从2007年初至2020年底，本研究纳入了2749例基线时LDL-C低于1.4 mmol/L且经冠状动脉造影诊断为CAD的个体。根据NLR水平将选定人群分为四组，主要采用Cox回归模型评估NLR与心血管及全因死亡率之间的关联。中位随访6年后，共发生182例心血管死亡和460例全因死亡。完全调整模型的Cox回归分析显示，在第四四分位数组中，NLR升高与心血管原因死亡率（HR：2.18，95%CI：1.38 - 3.43）和全因死亡率（HR：1.33，95%CI：1.02 - 1.74）较高相关。亚组分析表明，年轻和中年患者以及多支冠状动脉疾病患者可能具有更高的残余炎症风险。