title: Usefulness of the neutrophil-to-lymphocyte ratio to predict bare-metal stent restenosis.
abstract: Inflammation plays a crucial role in the pathogenesis of in-stent restenosis (ISR). Neutrophil-to-lymphocyte ratio (NLR) provides a simple method for assessment of inflammatory status and prognosis in patients with coronary artery disease. The aim of the present study was to investigate the predictive value of preprocedural NLR on development of ISR in patients undergoing coronary stent implantation. We retrospectively analyzed clinical, hematologic, and angiographic data of 624 patients (mean age 60.5 ± 10.2 years, 71.8% men) who had undergone coronary stent implantation and a further control coronary angiography owing to stable or unstable angina pectoris. Patients were divided into 3 tertiles based on preprocedural NLR. Restenosis occurred in 21 patients (10.1%) in the lowest tertile, in 62 (29.8%) in the middle tertile, and in 107 (51.4%) in the highest NLR tertile (p <0.001). Serum C-reactive protein levels were also significantly higher in patients in tertile 3 than in those in tertiles 1 and 2 (p <0.001). Using multiple logistic regression analysis, smoking, diabetes mellitus, stent length, preprocedural NLR, and C-reactive protein levels emerged as independent predictors of ISR. In receiver operating characteristics curve analysis, NLR >2.73 had 80% sensitivity and 75% specificity in predicting ISR. In conclusion, high preprocedural NLR is a powerful and independent predictor of bare-metal stent restenosis in patients with stable and unstable angina pectoris.
authors.affiliation: Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Turak
authors.forename: Fırat
authors.initials: F
authors.lastname: Ozcan
authors.forename: Ahmet
authors.initials: A
authors.lastname: Isleyen
authors.forename: Derya
authors.initials: D
authors.lastname: Tok
authors.forename: Erdogan
authors.initials: E
authors.lastname: Sokmen
authors.forename: Eyup
authors.initials: E
authors.lastname: Buyukkaya
authors.forename: Sinan
authors.initials: S
authors.lastname: Aydogdu
authors.forename: Mahmut
authors.initials: M
authors.lastname: Akpek
authors.forename: Mehmet G
authors.initials: MG
authors.lastname: Kaya
mesh_terms: D000789:Angina, Unstable / Q000601:surgery*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods*; D009504:Neutrophils / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D011475:Prosthesis Failure; D012189:Retrospective Studies; D015607:Stents