Abstract
BackgroundInflammation is involved in the pathogenesis and progression of coronary artery diseases (CADs), including acute coronary syndrome. The neutrophil-to-lymphocyte ratio (NLR) has been identified as a novel marker of the pro-inflammatory state. We aimed to evaluate the predictive efficacy of the NLR for the prognosis of patients with new-onset ACS.MethodsWe retrospectively included consecutive patients with new-onset ACS treated with emergency coronary angiography. NLR was measured at baseline and analyzed by tertiles. The severity of coronary lesions was evaluated by the Gensini score. Correlations of NLR with the severity of CAD and the incidence of major adverse cardiovascular diseases (MACEs) during follow-up were determined.ResultsOverall, 737 patients were included. The NLR was positively correlated with the severity of coronary lesions as assessed by Gensini score (P < 0.05). During the follow-up period (mean, 43.49 ± 23.97 months), 65 MACEs occurred. No significant association was detected between baseline NLR and the risk of MACEs during follow-up by either Kaplan–Meier or Cox regression analysis. Multivariable logistic regression analysis showed that a higher NLR was independently associated with coronary lesion severity as measured by the Gensini score (1st tertile vs. 3rd tertile hazard ratio [HR]: 0.527, P < 0.001, and 2nd tertile vs. 3rd tertile HR: 0.474, P = 0.025).ConclusionsThe NLR may be associated with coronary disease severity at baseline but is not associated with adverse outcomes in patients with new-onset ACS.Ethics Approval Number2019XE0208
Highlights
Inflammation is involved in the pathogenesis and progression of coronary artery diseases (CADs), including acute coronary syndrome
The baseline characteristics of the included patients according to the tertiles of neutrophil-to-lymphocyte ratio (NLR) are shown in Table 1.The results showed that patients with a higher NLR were more likely to have dyslipidemia and Stent thrombosis (ST)-elevation myocardial infarction (STEMI; both P < 0.05)
No significant differences in the incidences of all-cause mortality, overall and components of Major adverse cardiovascular events (MACE), or bleeding events were detected among the three groups
Summary
Inflammation is involved in the pathogenesis and progression of coronary artery diseases (CADs), including acute coronary syndrome. White blood cell count, a clinical marker of universal inflammation, was shown to be independently associated with the risk of mortality and incidence of major adverse cardiovascular events (MACEs) in ACS patients [10, 11]. Recent studies showed that the neutrophil-to-lymphocyte ratio (NLR), which incorporates two major subgroups of white blood cells, may confer prognostic efficacy in many diseases, including inflammatory diseases, cardiovascular diseases, and malignancies [13, 14]. The role of the NLR for the management of patients with coronary artery disease (CAD) has been evaluated, and the results showed that the NLR is correlated with CAD severity [16,17,18] These studies were of limited scale and patients with a previous diagnosis of CAD were not excluded. Clinical and experimental data support an important role for inflammation in CAD [1, 2]
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