Relationship between hematologic parameters and left ventricular systolic dysfunction in stable patients with multi-vessel coronary artery disease [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2012; 40(8): 706-713 | DOI: 10.5543/tkda.2012.82429

Relationship between hematologic parameters and left ventricular systolic dysfunction in stable patients with multi-vessel coronary artery disease

Orhan Doğdu1, Mahmut Akpek2, Mikail Yarlıoğlueş2, Nihat Kalay2, İdris Ardıç2, Deniz Elçik2, Ömer Şenarslan1, Mehmet Güngör Kaya2
1Department of Cardiology, Yozgat State Hospital, Yozgat, Turkey
2Department of Cardiology, Medicine Faculty of Erciyes University, Kayseri, Turkey


OBJECTIVES
Multi-vessel coronary artery disease (MVCAD) has long been recognized as an important predictor of adverse outcomes in patients with chronic stable angina. The aim of this study is to investigate the relationship between hematologic parameters and impairment of left ventricular systolic functions in patients with stable MVCAD.

STUDY DESIGN
Patients (n=202) with stable angina and MVCAD were included in this study. According to the left ventricle ejection fraction (LVEF) determined by echocardiography, patients were divided into two groups as the preserved group (LVEF >50%) and the impaired group (LVEF <50%). The preserved group consisted of 106 patients and the impaired group consisted of 96 patients.

RESULTS
The frequency of diabetes mellitus was significantly higher in the impaired group compared to the preserved group (respectively, 50% vs. 33%, p=0.01). High sensitivity C-reactive protein (hs-CRP) levels and, neutrophil/lymphocyte ratio (N/L ratio) were significantly higher in the impaired group than in the preserved group (3.9±2.4 vs. 7.9±3.8, p<0.001; 2.7±0.7 vs. 3.9±1.2, p<0.001, respectively). There was a significant correlation between LVEF, N/L ratio and hs-CRP; hs-CRP and N/L ratio were positively correlated (r=0.584; p<0.001), and LVEF was negatively correlated with both hs-CRP and N/L ratio (r=-0.48, p<0.001 and r=-0.43, p<0.001, respectively). A N/L ratio >3.0 had 77% sensitivity and 68% specificity in predicting left ventricular dysfunction in patients with stable MVCAD. In multivariate analysis, N/L ratio (OR: 2.456, <95% Cl 2.056–4.166; p<0.001) was an independent predictor of left ventricular dysfunction in stable patients with MVCAD.

CONCLUSION
N/L ratio and hs-CRP, which is inexpensive and easily measurable in the laboratory, is independently associated with impaired LV systolic functions in patients with stable MVCAD.

Keywords: C-reactive protein/analysis, coronary artery disease, multivariate analysis

How to cite this article
Orhan Doğdu, Mahmut Akpek, Mikail Yarlıoğlueş, Nihat Kalay, İdris Ardıç, Deniz Elçik, Ömer Şenarslan, Mehmet Güngör Kaya. Relationship between hematologic parameters and left ventricular systolic dysfunction in stable patients with multi-vessel coronary artery disease. Turk Kardiyol Dern Ars. 2012; 40(8): 706-713

Corresponding Author: Orhan Doğdu, Türkiye
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