title: Association of Neutrophil/Lymphocyte Ratio with Plaque Morphology in Patients with Asymptomatic Intermediate Carotid Artery Stenosis.
abstract: OBJECTIVE
  Non-calcified carotid plaques are more unstable than calcified plaques, and they are associated with a higher risk of rupture, thromboembolism, and consequently, stroke. The purpose of the present study is to compare calcified and non-calcified plaques that cause intermediate carotid artery stenosis with respect to neutrophil/lymphocyte ratio (NLR).
  
  
  METHODS
  A total number of 139 asymptomatic patients with 50-70% stenosis of the carotid artery were included in this study. Carotid Doppler ultrasound imaging and computed tomography angiography were performed to divide the carotid artery plaques into two groups as calcified and non-calcified. Patients included in the calcified (n=73) and non-calcified (n=66) plaque groups were compared with respect to total neutrophil count, lymphocyte count and NLR.
  
  
  RESULTS
  Total lymphocyte count was statistically significantly lower in the non-calcified plaque group compared to the calcified plaque group (total lymphocyte count in non-calcified/calcified plaque groups [103/mm3]: 2.1/2.3, respectively) (p=0.002). NLR was statistically significantly higher in the non-calcified plaque group compared to the calcified plaque group (NLR in non-calcified/calcified plaque groups: 2.6/2.1, respectively) (p<0.001). The cut-off value for NLR was found to be >2.54. Multivariate regression analysis showed that NLR was independently associated with non-calcified carotid artery plaques (odds ratio 5.686, 95% CI 2.498-12.944, p<0.001).
  
  
  CONCLUSIONS
  NLR is increased in the presence of non-calcified carotid artery plaques that cause asymptomatic intermediate stenosis. Increased NLR can be used as a marker to assess the risk of rupture of non-calcified carotid artery plaques.
authors.affiliation: Clinic of Cardiology, Antalya Education and Research Hospital, Antalya, Turkey.
authors.forename: İsa Öner
authors.initials: İÖ
authors.lastname: Yüksel
authors.affiliation: Clinic of Cardiology, Antalya Education and Research Hospital, Antalya, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Köklü
authors.affiliation: Clinic of Cardiology, Antalya Education and Research Hospital, Antalya, Turkey.
authors.forename: Şakir
authors.initials: Ş
authors.lastname: Arslan
authors.affiliation: Clinic of Cardiology, Antalya Education and Research Hospital, Antalya, Turkey.
authors.forename: Göksel
authors.initials: G
authors.lastname: Çağırcı
authors.affiliation: Clinic of Neurology, Antalya Education and Research Hospital, Antalya, Turkey.
authors.forename: Eylem Özaydın
authors.initials: EÖ
authors.lastname: Göksu
authors.affiliation: Clinic of Radiology, Antalya Education and Research Hospital, Antalya, Turkey.
authors.forename: Pınar
authors.initials: P
authors.lastname: Koç
authors.affiliation: Clinic of Cardiology, Türkiye Yüksek İhtisas Education and Research Hospital, Ankara, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Çay
authors.affiliation: Department of Cardiology, Medipol University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Filiz
authors.initials: F
authors.lastname: Kızılırmak
keywords: Atherosclerosis; Atherosclerotic plaque; Carotid artery stenosis; Neutrophil, lymphocyte, ratio; Stroke