title: Relation of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio with coronary artery disease severity in patients undergoing coronary angiography.
abstract: BACKGROUND
  Atherosclerosis is a chronic systemic inflammatory disease. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are systemic inflammatory markers that are correlated with poor cardiovascular outcomes.
  
  
  OBJECTIVE
  To explore the relation of NLR and PLR with severity of coronary artery disease (CAD).
  
  
  METHODS
  The study population consisted of 180 consecutive patients who underwent elective coronary angiography (CAG). While 100 patients (22 female, mean age: 60.6 ± 12.6 years) had abnormal CAG, 80 patients (44 female, mean age: 57.2 ± 10.9 years) had normal CAG. NLR and PLR were calculated as the ratio of neutrophil count to lymphocyte count and as the ratio of platelet count to lymphocyte count, respectively.
  
  
  RESULTS
  Although age distribution was similar between the two groups (p = 0.073), female gender was significantly higher in the normal CAG group (p < 0.001). Patients with abnormal CAG had significantly higher NLR and PLR when compared to patients with normal CAG (3.7 ± 2.6 vs. 2.2 ± 1.7, p < 0.001 and 125.9 ± 72.3 vs. 102.6 ± 33.8, p = 0.027, respectively). NLR and PLR were significantly correlated with SYNTAX score and GENSINI score. In logistic regression analyses, only NLR (odds ratio: 1.576, confidence interval: 1.198-2.072, p = 0.001) was an independent predictor of CAD. An NLR of 2.3 or higher predicted the CAD with a sensitivity of 66% and specificity of 70%.
  
  
  CONCLUSIONS
  NLR and PLR seem to be a simple method to predict severity of CAD in patients undergoing elective CAG, and it may be part of cardiovascular examination before CAG.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Sari
authors.affiliation: Department of Cardiology, Marmara University Faculty of Medicine, Istanbul, Turkey. drsunbul@yahoo.com.tr.
authors.forename: Murat
authors.initials: M
authors.lastname: Sunbul
authors.forename: Ceyhun
authors.initials: C
authors.lastname: Mammadov
authors.forename: Erdal
authors.initials: E
authors.lastname: Durmus
authors.forename: Mehmet
authors.initials: M
authors.lastname: Bozbay
authors.forename: Tarik
authors.initials: T
authors.lastname: Kivrak
authors.forename: Fethullah
authors.initials: F
authors.lastname: Gerin
mesh_terms: D000368:Aged; D015415:Biomarkers; D001772:Blood Cell Count; D001792:Blood Platelets; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007249:Inflammation; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers
keywords: GENSINI; SYNTAX; coronary artery disease; neutrophil-to-lymphocyte ratio; platelet-to-lymphocyte ratio