Relationship Between Coronary Lesion Severity Detected in Fractional Flow Reserve with Monocyte/High-Density Lipoprotein, Neutrophil/ Lymphocyte, Lymphocyte/Monocyte, and Platelet/ Lymphocyte Ratios: Which Is Most Important?

Abstract

Objective: In this study, in patients with moderate coronary lesions evaluated in coronary angiography, fractional flow reserve by lesion severity, we aimed to determine the relationship between neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, lymphocyte/monocyte ratio, and monocyte/high-density lipoprotein cholesterol ratio, which has been recently expressed as a predictor of cardiovascular disease risk. Methods: Stenosis with a fractional flow reserve of <0.80 was considered functionally severe. According to fractional flow reserve lesion severity, a total of 131 patients were analyzed, with fractional flow reserve > 0.8 (group 1) and fractional flow reserve < 0.8 (group 2). Patients with acute coronary syndrome, severe arrhythmia, hemodynamic instability, history of previous revascularization, severe renal and hepatic failure, active infection, malignancy, hematologic disease, familial history of hyperlipidemia, rheumatologic disease, life expectancy <1 year, and age <18 and >90 years were excluded from the study. Results: There was a statistically significant difference between monocyte/high-density lipoprotein cholesterol ratio, neutrophil /lymphocyte ratio, lymphocyte/monocyte ratio, and platelet/lymphocyte ratio, and fractional flow reserve groups (P <.001). Univariate and multivariate regression analyses were applied among the factors affecting the severity of the lesion detected in fractional flow reserve. Monocyte/high-density lipoprotein cholesterol ratio (odds ratio, 1.25; 95% CI, 1.05-1.47; P =.004), neutrophil/lymphocyte ratio (odds ratio, 3.15; 95% CI, 1.51-6.57; P <.001), hemoglobin A1c (odds ratio, 11.5; 95% CI, 2.76-48.4; P =.001), and lymphocyte/monocyte ratio (odds ratio, 0.27; 95% CI, 0.16-0.44; P =.002) were found to be independent predictors. Conclusions: In this study, we would like to emphasize that simple, fast, and low-cost methods such as monocyte/high-densit y lipoprotein cholesterol ratio, neutrophil/lymphocyte ratio, lymphocyte/monocyte ratio, and platelet/lymphocyte ratio can be parameters related to lesion severity detected in fractional flow reserve. These parameters can be widely used as they are easily accessible and repeatable.