Combination of change in hematological parameters with exercise stress test to predict coronary artery disease.
OBJECTIVE
Treadmill exercise stress testing for identifying patients with a higher likelihood of coronary artery disease (CAD) before elective coronary angiography is recommended in the current guidelines. In this study, we aimed to evaluate the changes in the hematological parameters before and after exercise stress test in relation with the presence of CAD.


METHODS
A total of 113 patients with chest pain who underwent treadmill exercise testing and coronary angiography were included in this study.


RESULTS
Neutrophil count (4.38±0.99 vs 5.19±0.93, P<.001), and neutrophil to lymphocyte ratio (NLR) (2.04±0.63 vs 2.41±0.78, P<.001) were significantly elevated after treadmill exercise test in all the patients. Increase in the NLR after exercise test was significantly higher in patients with positive exercise test (n=68) than negative exercise test (n=45) (0.49±0.58 vs 0.19±0.44, P=.016). The sensitivity and specificity of treadmill exercise testing according to coronary angiography was 79% and 64%, respectively. A cut-off point of 0.2 for the change in the NLR in addition to positive treadmill exercise testing had 91% sensitivity and 92% specificity in predicting significant coronary artery stenosis (AUC:0.913, 95% CI: 0.805-1.000, P<.001).


CONCLUSIONS
Neutrophil to lymphocyte ratio is an important inflammatory marker that can contribute to treadmill ECG testing in predicting CAD.
Cardiology Clinic, Ankara Numune Training Hospital, Ankara, Turkey.
Ahmet
A
Korkmaz
Cardiology Clinic, Private Anadolu Hospital, Kastamonu, Turkey.
Abdulkadir
A
Yıldız
Cardiology Clinic, Ankara Numune Training Hospital, Ankara, Turkey.
Pınar
P
Türker Duyuler
Cardiology Clinic, Acıbadem Ankara Hospital, Ankara, Turkey.
Serkan
http://orcid.org/0000-0002-9240-9158
S
Duyuler
Cardiology Clinic, Yozgat State Hospital, Yozgat, Turkey.
Samet
S
Yılmaz
Cardiology Clinic, Ankara Numune Training Hospital, Ankara, Turkey.
Funda
F
Basyigit
Cardiology Clinic, Ankara Numune Training Hospital, Ankara, Turkey.
Ozgul Ucar
OU
Elalmis
Cardiology Clinic, Ankara Numune Training Hospital, Ankara, Turkey.
Umit
U
Guray
Cardiology Clinic, Ankara Numune Training Hospital, Ankara, Turkey.
Mehmet
M
Ileri
D002637:Chest Pain; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D005080:Exercise Test / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007958:Leukocyte Count / Q000706:statistics & numerical data; D008214:Lymphocytes / Q000166:cytology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology; D012372:ROC Curve
coronary artery disease; exercise stress test; neutrophil count; neutrophil to lymphocyte ratio