title: Association between neutrophil-lymphocyte ratio and impaired myocardial perfusion in patients with known or suspected coronary disease.
abstract: OBJECTIVE
  To determine whether an elevated neutrophil-lymphocyte ratio (NLR) is associated with chronically impaired myocardial perfusion in patients with known or suspected coronary disease.
  
  
  BACKGROUND
  Elevated NLRs are positively associated with cardiac events, anatomic coronary disease, and myocardial infarct size. However, no study has evaluated the association between NLR and chronically impaired myocardial perfusion.
  
  
  METHODS
  This study included 683 patients undergoing cardiac positron emission tomography (PET) with a calculable NLR within 90 days of PET. The primary outcome was myocardial perfusion defect size measured in percent of left ventricular mass (%LV60).
  
  
  RESULTS
  NLR was independently associated with %LV60 when analyzed as both a continuous and binary outcome (p < 0.001). Individuals with NLR above the 90th percentile had a 5-fold increased likelihood of significant perfusion defects compared to individuals with NLR between the 10th and 25th percentiles (Odds ratio = 4.7, p < 0.001).
  
  
  CONCLUSIONS
  An elevated NLR demonstrated strong associations with myocardial perfusion.
authors: Geisinger Health System, Geisinger Center for Health Research, 100 North Academy Avenue, Danville, PA 17822, USA. Electronic address: bawilliams2@geisinger.edu.
authors: Brent A
authors: BA
authors: Williams
authors: Michael E
authors: ME
authors: Merhige
mesh_terms: D000368:Aged; D003326:Coronary Circulation / Q000276:immunology*; D003327:Coronary Disease / Q000276:immunology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D049268:Positron-Emission Tomography
keywords: CABG; CAD; Inflammation; LV; Lymphocyte; MI; Myocardial perfusion; NLR; Neutrophil; PCI; PET MPI; WBC; White blood cell; coronary artery bypass graft; coronary artery disease; left ventricular; myocardial infarction; neutrophil–lymphocyte ratio; pCAD; percutaneous coronary intervention; positron emission tomography myocardial perfusion imaging; pre-test probability of coronary artery disease; white blood cell