Neutrophil-to-lymphocyte ratio predicts functionally significant coronary artery stenosis in patients with stable coronary artery disease [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2018; 46(2): 129-135 | DOI: 10.5543/tkda.2017.16709

Neutrophil-to-lymphocyte ratio predicts functionally significant coronary artery stenosis in patients with stable coronary artery disease

Samet Yılmaz1, Uğur Canpolat2, Kazim Başer1, Sefa Ünal1, Mevlüt Serdar Kuyumcu1, Sinan Aydoğdu1
1Department of Cardiology, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey
2Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey


OBJECTIVE
The aim of this study was to determine the relationship between the neutrophil-to-lymphocyte ratio (NLR) and the functional severity of coronary stenosis assessed according to the fractional flow reserve (FFR) in stable coronary artery disease (CAD).

METHODS
The clinical and laboratory data of 420 patients who underwent index coronary angiography for stable angina pectoris were analyzed retrospectively. The functional severity of an intermediate lesion was determined by FFR. An FFR value of >0.80 was considered non-significant (Group 1), whereas ≤0.80 was accepted as significant stenosis (Group 2).

RESULTS
A total of 137 (32.6%) patients had functionally significant coronary artery stenosis. The median NLR value was significantly greater in Group 2 compared with Group 1 [3.13 (0.93–9.75) vs 2.22 (0.75–6.02); p<0.001]. In multivariable logistic regression analysis, the Gensini score [odds ratio (OR): 1.04; 95% confidence interval (CI): 1.02–1.06; p<0.001], diabetes mellitus (OR: 2.56; 95% CI: 1.38–4.75; p=0.003), smoking (OR: 2.09; 95% CI: 1.12–3.94; p=0.021), and NLR (OR: 1.62; 95% CI: 1.26–2.09; p<0.001) were found to be independent predictors of the presence of functionally significant coronary stenosis using an FFR value of ≤0.80. The optimal cut-off value of NLR for predicting functionally significant coronary stenosis was 2.3. An NLR value greater than 2.3 had a sensitivity of 72% and a specificity of 61% to predict stenosis with an FFR value of ≤0.80.

CONCLUSION
The pre-angiographic NLR is a simple, noninvasive, and inexpensive biomarker that was significantly higher in patients with functionally significant coronary stenosis; it can be used to predict the hemodynamic severity of intermediate coronary stenosis in patients with stable CAD.

Keywords: Coronary artery disease, fractional flow reserve; neutrophil-to-lymphocyte ratio.

How to cite this article
Samet Yılmaz, Uğur Canpolat, Kazim Başer, Sefa Ünal, Mevlüt Serdar Kuyumcu, Sinan Aydoğdu. Neutrophil-to-lymphocyte ratio predicts functionally significant coronary artery stenosis in patients with stable coronary artery disease. Turk Kardiyol Dern Ars. 2018; 46(2): 129-135

Corresponding Author: Uğur Canpolat, Türkiye
© Copyright 2018 Archives of the Turkish Society of Cardiology
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