Value of 2D echo calcium score and neutrophil/lymphocyte ratio as simple tools for the prediction of coronary artery disease documented by multislice computed tomography in type II diabetic patients

Abstract

Background Early detection of coronary artery disease (CAD) among patients with type II diabetes mellitus (DM) constitutes an important task. Neutrophil-lymphocytic ratio (NLR) and echo calcium score (eCS) have been recently identified as independent predictors of CAD. Aim The study aimed to assess the value of 2D echo calcium score and NLR as simple tools for the prediction of CAD documented by multislice computed tomography in type II diabetic patients. Patients and methods The study included 40 male patients with type II DM and known risk factors for CAD, who were referred for coronary computed tomography (CT) due to suspected CAD. NLR and eCS were assessed in all patients. Coronary calcium score and the presence of obstructive CAD were assessed by CT coronary angiography. Results Patients were divided into two groups according to the presence of CAD; group I (18 patients) with nonobstructive CAD and group II (22 patients) with obstructive CAD. The authors found that patients in group II had significantly higher NLR, eCS, and coronary artery calcium score (CACS) compared with group I. There was a weak positive correlation between NLR and coronary calcium score and a strong positive correlation between eCS and CACS. The best sensitivity and specificity of eCS and NLR were 77.3, 66.7 and 77.3, 61.1%, respectively, when used alone to predict obstructive CAD. However, when combining NLR and eCS, the capability to predict obstructive CAD increased with sensitivity (90.9%) and specificity (72.2%). Conclusion NLR and eCS had the capability to predict obstructive CAD detected by CT coronary angiography in patients with type II DM.