title: Association of Neutrophil-to-Lymphocyte Ratio with the Severity and Morphology of Coronary Atherosclerotic Plaques Detected by Multidetector Computerized Tomography.
abstract: BACKGROUND
  Studies have demonstrated a consistent relationship between white blood cell (WBC) counts and coronary artery disease (CAD). The neutrophil/lymphocyte ratio (NLR) has been considered as a potential marker for identifying individuals under risk of CAD and associated events. In this study, we aimed to evaluate whether NLR was associated with the severity and morphology of coronary atherosclerotic plaques shown by multidetector computed tomography (MDCT).
  
  
  METHODS
  Our study population consisted of 684 patients who underwent dual-source 64 slice MDCT for the assessment of CAD. Coronary arteries were evaluated on a 16-segment basis and critical coronary plaque was described as luminal narrowing > 50%, whereas plaque morphology was assessed on a per segment basis. Total WBC, neutrophil and lymphocyte counts were determined using commercially available assay kits.
  
  
  RESULTS
  WBC count [7700 (6400-8800) vs. 6800 (5700-7900), p < 0.05] and NLR [2.40 (1.98-3.07) vs. 1.86 (1.50-2.38), p < 0.001] were found to be higher in patients with critical stenosis than in those without. In the binary logistic regression analysis, NLR was a predictor of critical stenosis (odds ratio, 1.68; 95% confidence interval, 1.39-2.03, p < 0.001). NLR levels differed among plaque morphology subtypes (p < 0.05) and was significantly higher in non-calcified plaque (NCP) compared to mixed plaque (MP) and calcified plaque (CP) (p < 0.05). In the multinomial logistic regression analysis, NLR was found to be an independent predictor of NCP, MP and CP (p < 0.001).
  
  
  CONCLUSIONS
  These data show that NLR is associated with both the severity and morphology of coronary atherosclerotic disease.
authors.affiliation: Samsun Training and Research Hospital, Cardiology Clinic, Samsun.
authors.forename: Ahmet Hakan
authors.initials: AH
authors.lastname: Ateş
authors.affiliation: Department of Cardiology.
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.affiliation: Department of Cardiology.
authors.forename: Duygu
authors.initials: D
authors.lastname: Koçyiğit
authors.affiliation: Department of Cardiology.
authors.forename: Muhammed Ulvi
authors.initials: MU
authors.lastname: Yalcin
authors.affiliation: Department of Cardiology.
authors.forename: Kadri Murat
authors.initials: KM
authors.lastname: Gürses
authors.affiliation: Department of Cardiology.
authors.forename: Hikmet
authors.initials: H
authors.lastname: Yorgun
authors.affiliation: Department of Cardiology.
authors.forename: Uğur
authors.initials: U
authors.lastname: Canpolat
authors.affiliation: Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Tuncay
authors.initials: T
authors.lastname: Hazırolan
authors.affiliation: Samsun Training and Research Hospital, Cardiology Clinic, Samsun.
authors.forename: Necla
authors.initials: N
authors.lastname: Özer
keywords: Atherosclerosis; Coronary plaque; Inflammation; Multidetector computerized tomography