Archives of the Turkish Society of Cardiology
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. Ahead of Print: TKDA-16709 | 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
1Cardiology Clinic, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
2Department of Cardiology, Hacettepe University, Ankara, Turkey


BACKGROUND
Fractional flow reserve (FFR) is a gold standard test for assessment of functional severity of intermediate coronary lesions. Neutrophil to lymphocyte ratio (NLR) was significantly associated with the presence and extent of a coronary artery disease (CAD).
Aims: We aimed to determine the relationship between NLR and the functional severity of coronary stenosis assessed by FFR in stable CAD.
Study Design: 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. FFR value of >0,80 was considered as 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. Median NLR value was significantly higher in group 2 compared to group 1 [3,13 (0.93-9,75) vs 2,22 (0,75-6,02), p<0,001]. In multivariable logistic regression analysis, Gensini score (OR: 1,04; 95%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 for the presence of functionally significant coronary stenosis using FFR value of ≤0,80. The optimal cut-off value of NLR for predicting functionally significant coronary stenosis was 2,3. Any NLR value greater than 2,3 has a sensitivity of 72% and a spesificity of 61% to predict FFR value of ≤0,80.

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

Keywords: Neutrophil to lymphocyte ratio, fractional flow reserve, coronary artery disease

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Corresponding Author: Uğur Canpolat, Türkiye
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