Abstract
Introduction Atherosclerosis is a low-grade inflammatory disease. Among markers of inflammation, importance has been given to the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR). The objective of this study was to examine the association between these hematological indices of inflammation and coronary atherosclerotic calcification in clinically asymptomatic patients. Methods This study had clinical and laboratorial data collected from consecutive asymptomatic patients that underwent computed tomography coronary artery calcium (CAC) scoring. Risk factors, NLR, and PLR were evaluated at different categories of CAC scoring. Statistical tests included chi-square, linear regression, and logistic regression. Patients (N = 247; age 60.4 ± 8.0 years and 60.7% men) were allocated into four categories according to the CAC score. Results Respective age, sex (male), NLR, and PLR distribution within groups were as follows: CAC = 0 (n = 98; 52.5 ± 13.6 years, 55%, 2.0 ± 1.0, and 121.5 ± 41.5), CAC 1-100 (N = 64; 61.3 ± 11.0 years, 60%, 2.2 ± 1.2, and 125.6 ± 45.6), CAC 101-400 (N = 37; 64.2 ± 11.6 years, 67%, 2.6 ± 1.3, and 125.4 ± 55.9), and CAC > 400 (N = 48; 69.3 ± 11.1 years, 66%, 3.3 ± 2.0, and 430.1 ± 1787.4). The association between risk factors and CAC score was assessed. Hypertension status and smoking status were similar within groups, while the presence of diabetes (P = 0.02) and older age (P ≤ 0.001) was more prevalent in the CAC > 400 group. LDL cholesterol was greater in the higher CAC score groups (P = 0.002). Multivariate logistic regression of the quartile analysis showed that age and NLR were independently associated with CAC > 100 (OR (CI), P value): 2.06 (1.55-2.73, P = 0.00001) and 1.82 (1.33-2.49, P = 0.0002), respectively. Conclusion Within asymptomatic patients, NLR provides additional risk stratification, as an independent association between NLR extent and CAD extent was identified. Moreover, PLR was not an inflammation marker for CAD severity.
Highlights
Among markers of inflammation involved in atherosclerosis, increasing importance has been given to circulating blood components, such as subtype leukocyte and platelet counts, and future cardiovascular events in healthy subjects [3, 4]
Recent research has revealed a significant association between cardiovascular risk and the Mediators of Inflammation neutrophil-lymphocyte ratio (NLR) [5, 6] and plateletlymphocyte ratio (PLR) [7, 8]
It is well understood that increases in markers of inflammation as well as the presence of coronary calcium enhance the probability of adverse short- and long-term cardiovascular events [24, 25]
Summary
Recent research has revealed a significant association between cardiovascular risk and the Mediators of Inflammation neutrophil-lymphocyte ratio (NLR) [5, 6] and plateletlymphocyte ratio (PLR) [7, 8]. PLR is a new prognostic marker that integrates the risk prediction of these 2 parameters into 1 It gives an idea about both the aggregation and inflammation pathways, and it may be more valuable than either platelet or lymphocyte count alone in the prediction of coronary atherosclerotic burden [16]. These markers offer an effective, simple, and relatively cheap tool for the diagnosis and prognosis of CAD events, even in the asymptomatic individuals
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