Abstract:
Objectives: The purpose of the study is to evaluate whether NLR adds additional information about presence and severity of coronary artery disease in patients referred for coronary angiography for various reasons.Background: White blood cell count is known to be an independent predictor of cardiovascular events and all-cause mortality [ ].The neutrophil-to-lymphocyte ratio (NLR) has been proposed as a prognostic marker and seemed to be related to a pro-inflammatory state imposing worse clinical outcomes in patients with cardiovascular disease [ ].Patients and methods: This prospective cohort study included 101 patients who were referred to Assiut University Hospital for coronary angiography for various reasons including chronic stable angina, unstable angina, and myocardial infarction. NLR is calculated by taking the absolute neutrophil count and dividing it by the absolute lymphocyte count. Coronary artery disease (CAD) severity was determined by an interventional cardiologist unaware of the study aims. The association between NLR and CAD severity was assessed by logistic regression.Results: Our patients divided into 3 groups according to the value of NLR (<2, 2-3, and >3). NLR was independently associated with CAD severity and contributed significantly to the regression models. Patients with NLR >3 had more advanced obstructive CAD (OR = 3.56, CI 95% 1.76-3.42, p = 0.001). They were further divided according to the severity of coronary artery stenosis into three categories, i.e. 0-30%, 30-70% and more than 70% (groups 1-3). NLR increase as the severity of coronary artery stenosis increases, the mean NLR was 2.37+1.27 (p=0.007) and in patients who had severe lesions the mean neutrophil count was 2.55+0.98 (p=0.008).Conclusion: NLR is a simple marker which can be derived from a routine complete blood count test was significantly and independently related to presence and severity of coronary atherosclerosis.