title: Blood count parameters can predict the severity of coronary artery disease.
abstract: OBJECTIVE
  Because of the inflammatory nature of coronary artery disease (CAD), both platelets and white blood cells have been investigated for years. The aim of this study was to investigate the relationships between some prominently hematologic blood count parameters (mean platelet volume [MPV], neutrophil to lymphocyte ratio [NLR]) and the severity of CAD by using Gensini scores.
  
  
  METHODS
  A total of 194 patients, who had undergone coronary angiography, enrolled in this study. The control group consisted of 42 patients who had normal coronary arteries. Remaining CAD patients were divided into two groups according to their Gensini scores.
  
  
  RESULTS
  NLR and MPV were higher in the severe atherosclerosis group compared with the mild atherosclerosis group (p= 0.007,p= 0.005, respectively). The Gensini score showed significant correlations with NLR (r= 0.20,p= 0.011), MPV (r= 0.23,p= 0.004) and high density lipoprotein cholesterol (r= -0.161,p= 0.047). Using a cut-off level of 2.54, NLR predicted severe atherosclerosis with a sensitivity of 74% and specificity of 53% (area under curve [AUC], 0.627; 95% confidence interval [CI], 0.545 to 0.704;p= 0.004). MPV values above 10.4 predicted severe atherosclerosis with a sensitivity of 39% and specificity of 90% (AUC, 0.631; 95% CI, 0.549 to 0.708;p= 0.003). In the multiple logistic regression analysis, high levels of NLR (odds ratio [OR], 1.450; 95% CI, 1.080 to 1.945;p= 0.013) and MPV (OR, 1.622; 95% CI, 1.147 to 2.295;p= 0.006) were found to be independent predictors of severe atherosclerosis.
  
  
  CONCLUSIONS
  Our study suggests that both NLR and MPV are predictors of severe atherosclerosis and may be used for the prediction and identification of cardiac risks in CAD patients.
authors.affiliation: Department of Internal Medicine, Adnan Menderes University School of Medicine, Aydin, Turkey.
authors.forename: Hilal Bektas
authors.initials: HB
authors.lastname: Uysal
authors.affiliation: Department of Emergency, Adnan Menderes University School of Medicine, Aydin, Turkey.
authors.forename: Bekir
authors.initials: B
authors.lastname: Dağlı
authors.affiliation: Department of Cardiology, Adnan Menderes University School of Medicine, Aydin, Turkey.
authors.forename: Cağdaş
authors.initials: C
authors.lastname: Akgüllü
authors.affiliation: Department of Emergency, Adnan Menderes University School of Medicine, Aydin, Turkey.
authors.forename: Mücahit
authors.initials: M
authors.lastname: Avcil
authors.affiliation: Department of Cardiology, Adnan Menderes University School of Medicine, Aydin, Turkey.
authors.forename: Cemil
authors.initials: C
authors.lastname: Zencir
authors.affiliation: Department of Endocrinology, Adnan Menderes University School of Medicine, Aydin, Turkey.
authors.forename: Mediha
authors.initials: M
authors.lastname: Ayhan
authors.affiliation: Department of Internal Medicine, Adnan Menderes University School of Medicine, Aydin, Turkey.
authors.forename: Hulki Meltem
authors.initials: HM
authors.lastname: Sönmez
mesh_terms: D000368:Aged; D019540:Area Under Curve; D001792:Blood Platelets; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D016015:Logistic Models; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D063847:Mean Platelet Volume; D008875:Middle Aged; D015999:Multivariate Analysis; D009504:Neutrophils; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: Coronary artery disease; Gensini score; Mean platelet volume; Neutrophil to lymphocyte ratio