Abstract
The present study aimed to investigate the relationship between an increase in the pre- and post-operative neutrophil–lymphocyte ratio (NLR) and superficial femoral artery in-stent restenosis (ISR) rate. We recruited 199 patients that underwent superficial femoral artery stenting for lower extremity arteriosclerosis obliterans at our hospital from March 2015 to July 2018. Patients were divided into two groups according to the occurrence of ISR within 1 year (group 1, ISR and group 2, Non-ISR). The after NLR (NLRafter) and NLR change ratio (NLRratio) (P<0.001) were significantly higher in group 1. A NLRafter > 4.3 was associated with an odds ratio of 1.946 (95% CI [1.51–2.50]; P<0.001) for the presence of ISR. A NLRratio > 37.5% was associated with an odds ratio of 3.6 (95% CI [2.03–6.36]; P<0.001) for occurrence of ISR. A NLRafter level > 4.3 had 75% sensitivity and 76% specificity for the prediction of ISR, as identified by the ROC curve. A NLRratio level > 37.5% predicted ISR with 77% sensitivity and 60% specificity. Multivariate logistic regression analysis demonstrated that NLRratio was the strongest independent predictor of ISR (P<0.001). In conclusions, NLRratio could be used as a prognostic marker in superficial femoral artery stents.
Highlights
Arteriosclerosis obliterans of the lower limbs is caused by the formation of atherosclerotic plaques of the lower limbs, which leads to arterial stenosis and occlusion, leading to chronic limb ischemia
Percutaneous superficial femoral interventions are the preferred treatment for superficial femoral artery disease, even though the occurrence of in-stent restenosis (ISR) continues to be an important complication [1,2]
No studies have evaluated the effectiveness of the neutrophil–lymphocyte ratio (NLR) value after (NLRafter), NLR change(NLRchange), defined as the NLR value before (NLRbefore) and after (NLRafter) superficial femoral artery stenting (SFAS) intervention and NLR change ratio (NLRratio), defined as the ratio of NLRchange to NLRbefore, in prediction of ISR in superficial femoral artery stents, which are at high risk for the occurrence of ISR
Summary
Arteriosclerosis obliterans of the lower limbs is caused by the formation of atherosclerotic plaques of the lower limbs, which leads to arterial stenosis and occlusion, leading to chronic limb ischemia. Percutaneous superficial femoral interventions are the preferred treatment for superficial femoral artery disease, even though the occurrence of in-stent restenosis (ISR) continues to be an important complication [1,2]. Recent studies have shown that inflammatory processes play an important role in the occurrence and development of atherosclerosis, and in the occurrence of ISR [4,5]. No studies have evaluated the effectiveness of the NLR value after (NLRafter), NLR change(NLRchange), defined as the NLR value before (NLRbefore) and after (NLRafter) superficial femoral artery stenting (SFAS) intervention and NLR change ratio (NLRratio), defined as the ratio of NLRchange to NLRbefore, in prediction of ISR in superficial femoral artery stents, which are at high risk for the occurrence of ISR.
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