title: Relationship between hematologic parameters and left ventricular systolic dysfunction in stable patients with multi-vessel coronary artery disease.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiology, Yozgat State Hospital, Yozgat, Turkey. orhandogdu@yahoo.com
authors.forename: Orhan
authors.initials: O
authors.lastname: Doğdu
authors.forename: Mahmut
authors.initials: M
authors.lastname: Akpek
authors.forename: Mikail
authors.initials: M
authors.lastname: Yarlıoğlueş
authors.forename: Nihat
authors.initials: N
authors.lastname: Kalay
authors.forename: Idris
authors.initials: I
authors.lastname: Ardıç
authors.forename: Deniz
authors.initials: D
authors.lastname: Elçik
authors.forename: Omer
authors.initials: O
authors.lastname: Senarslan
authors.forename: Mehmet Güngör
authors.initials: MG
authors.lastname: Kaya
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D002097:C-Reactive Protein / Q000032:analysis; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology; D004452:Echocardiography; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009504:Neutrophils / Q000166:cytology; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000209:etiology* / Q000503:physiopathology
chemical_list: D002097:C-Reactive Protein