title: Monocyte/lymphocyte ratio predicts the severity of coronary artery disease: a syntax score assessment.
abstract: We aimed to explore whether monocyte to lymphocyte ratio (MLR) provides predictive value of the lesion severity in patients with coronary artery disease (CAD).
  
  
  
  Five hundred forty-three patients undergoing coronary angiography were analyzed in this retrospective study. Patients with coronary stenosis were divided into three groups on the basis of Syntax score. The control group consisted of patients with normal coronary arteries. MLR was calculated by dividing monocytes count by lymphocytes count obtained from routine blood examination. Multivariate logistic analysis was used to assess risk factors of CAD. Ordinal logistic regression analysis was used to assess the relationship between MLR and the lesion severity of coronary arteries.
  
  
  
  MLR was found to be an independent risk factor of the presence of CAD (OR: 3.94, 95% CI: 1.20-12.95) and a predictor of the lesion severity (OR: 2.05, 95% CI: 1.15-3.66). Besides, MLR was positively correlated with Syntax score(r = 0.437, p < 0.001). In the receiver-operating characteristic (ROC) curve analysis, MLR, with an optimal cut-off value of 0.25, predicted the severe coronary lesion with a sensitivity of 60.26% and specificity of 78.49%.
  
  
  
  MLR was an independent risk factor of the presence of CAD, and a predictor of the lesion severity. Compared to neutrophil to lymphocyte ratio (NLR), MLR has better performance to reflect the severity of coronary lesion.
authors.affiliation: Department of Cardiology, Civil Aviation General Hospital, Civil Aviation Clinical Medical College of Peking University, No.1, Gaojingjia, Chaoyang District, Beijing, 100100, China. hanhuaji@foxmail.com.
authors.forename: Hanhua
authors.initials: H
authors.lastname: Ji
authors.affiliation: Department of Cardiology, Civil Aviation General Hospital, Civil Aviation Clinical Medical College of Peking University, No.1, Gaojingjia, Chaoyang District, Beijing, 100100, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Cardiology, Civil Aviation General Hospital, Civil Aviation Clinical Medical College of Peking University, No.1, Gaojingjia, Chaoyang District, Beijing, 100100, China.
authors.forename: Zeyuan
authors.initials: Z
authors.lastname: Fan
authors.affiliation: Department of Cardiology, Peking University Third Hospital, Beijing, 100100, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zuo
authors.affiliation: Department of Cardiology, Civil Aviation General Hospital, Civil Aviation Clinical Medical College of Peking University, No.1, Gaojingjia, Chaoyang District, Beijing, 100100, China.
authors.forename: Xinwen
authors.initials: X
authors.lastname: Jian
authors.affiliation: Department of Cardiology, Civil Aviation General Hospital, Civil Aviation Clinical Medical College of Peking University, No.1, Gaojingjia, Chaoyang District, Beijing, 100100, China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Cardiology, Civil Aviation General Hospital, Civil Aviation Clinical Medical College of Peking University, No.1, Gaojingjia, Chaoyang District, Beijing, 100100, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Liu
mesh_terms: D000368:Aged; D019540:Area Under Curve; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging*; D023921:Coronary Stenosis / 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; D008875:Middle Aged; D009000:Monocytes; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: Coronary artery disease; Monocyte to lymphocyte ratio; Syntax score