title: Calcific aortic stenosis and its correlation with a novel inflammatory marker, the lymphocyte/monocyte ratio.
abstract: BACKGROUND
  Calcific aortic valve disease, a chronic progressive disorder, is the leading cause of valve replacement among elderly patients. The lymphocyte/monocyte ratio has been recently put forward as an inflammatory marker of relevance in several cancers as well as in cardiovascular disease. This study aims to assess the correlation between severity of calcific aortic stenosis and the lymphocyte/monocyte ratio.
  
  
  METHODS
  The study retrospectively included 178 patients with a diagnosis of calcific aortic stenosis and 139 age- and gender-matched controls. The patients were divided into two groups according to the severity of aortic stenosis: mild-to-moderate and severe.
  
  
  RESULTS
  An inverse correlation was discerned between the severity of the aortic stenosis process (mean gradient) and the lymphocyte/monocyte ratio (r=-0.232, p=0.002). The lymphocyte/monocyte ratio was observed to decrease as the severity of aortic stenosis increased (p<0.001) in the group with severe aortic stenosis compared with the mild-to-moderate aortic stenosis and control groups (p<0.001, p=0.005 respectively), and in the group with mild-to-moderate aortic stenosis compared with the control group (p=0.003). Multivariate regression analysis revealed that the lymphocyte/monocyte ratio was independently related to the severity of calcific aortic stenosis (p=0.003).
  
  
  CONCLUSIONS
  The present study demonstrated the existence of a statistically significant inverse relationship between severity of calcific aortic stenosis and the lymphocyte/monocyte ratio. The study also revealed that the lymphocyte/monocyte ratio was significantly related to the severity of the aortic valve stenosis process.
authors.affiliation: Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey. Electronic address: medisay@gmail.com.
authors.forename: Tolga Han
authors.initials: TH
authors.lastname: Efe
authors.affiliation: Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Kadriye
authors.initials: K
authors.lastname: Gayretli Yayla
authors.affiliation: Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
authors.forename: Cagri
authors.initials: C
authors.lastname: Yayla
authors.affiliation: Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
authors.forename: Ahmet Goktug
authors.initials: AG
authors.lastname: Ertem
authors.affiliation: Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Cimen
authors.affiliation: Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Hilal
authors.initials: H
authors.lastname: Erken Pamukcu
authors.affiliation: Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Bilgin
authors.affiliation: Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Erat
authors.affiliation: Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Dogan
authors.affiliation: Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Ekrem
authors.initials: E
authors.lastname: Yeter
mesh_terms: D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002114:Calcinosis / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000166:cytology*; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers
keywords: Calcific aortic stenosis; Echocardiography; Ecocardiografia; Estenose aórtica calcificada; Lymphocyte/monocyte ratio; Relação linfócito/monócito