Admission Neutrophil-to-lymphocyte ratio predicts coronary lesion complexity and clinical risk in patients with unstable angina pectoris

doi:10.12092/j.issn.1009-2501.2019.03.010

Abstract

Abstract:

AIM: To study the association of admission neutrophil-to-lymphocyte ratio (NLR) with coronary lesion complexity and prognosis as respectively evaluated by Gensini score and GRACE（global Registry of Acute Coronary Events，GRACE） score in patients with unstable angina pectoris. METHODS: A total of 156 cases were retrospectively analyzed. All patients were assigned into 3 groups according to their NLR tertiles（low NLR,LNLR；Medium NLR, MNLR；High NLR, HNLR）. Clinical characteristics, risk and angiographic complexity attached to the 3 groups were compared. RESULTS:HNLR group exhibited much higher age，rest heart rate，LDL-C and blood creatine values and percentages of smoking, hypertension, diabetes mellitus, ST depression as compared with LNLR group(all P<0.01). However，the use rate of statins in HNLR group was significantly lower than that in LNLR group (P<0.01). The GRACE risk score and Gensini score were all significantly higher in HNLR group compared to MNLR and LNLR groups (all P<0.01). Both GRACE and Gensini scores illustrated significant positive correlations with NLR. CONCLUSION:Admission NLR positively mirrors clinical risk and angiographic complexity in unstable angina patients.

Key words: inflammation, neutrophil-to-lymphocyte ratio, unstable angina pectoris

CLC Number:

R541.4

WANG Xiaqin， HE Fei, WANG Tong, HU Zhangle. Admission Neutrophil-to-lymphocyte ratio predicts coronary lesion complexity and clinical risk in patients with unstable angina pectoris[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2019, 24(3): 296-300.

References

［1］Vaccarezza M, Balla C, Rizzo P. Atherosclerosis as an inflammatory disease: Doubts? No more［J］. Int J Cardiol Heart Vasc, 2018,19:1-2.
［2］Rymer JA,Newby LK.Failure to launch:targeting inflammation in acute coronary syndromes［J］.JACC Basic Transl Sci,2017,2(4):484-497.
［3］Arshad MK, Bin Mohamad Fathil MF, Gopinath SC, et al. Cardiac biomarkers: invasive to non-invasive assessments［J］. Curr Med Chem, 2016,23(37):4270-4284.
［4］Lahdentausta L, Leskela J, Winkelmann A, et al. Serum MMP-9 diagnostics, prognostics, and activation in acute coronary syndrome and its recurrence［J］. J Cardiovasc Transl Res,2018,11(3):210-220.
［5］Sadeghi M, Gheraati M, Soleimani A, et al. Serum interleukin-18 and extent of coronary artery disease in unstable angina［J］. ARYA Atheroscler, 2018,14(3):122-127.
［6］Korzonek-Szlacheta I, Hudzik B, Danikiewicz A, et al. Pentraxin-3 and coronary artery disease［J］. Exp Gerontol, 2018,102:1-2.
［7］Horne BD, Anderson JL, John JM, et al. Which white blood cell subtypes predict increased cardiovascular risk［J］? J Am Coll Cardiol, 2005,45(10):1638-1643.
［8］Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill［J］. Bratisl Lek Listy, 2001,102(1):5-14.
［9］Tahto E, Jadric R, Pojskic L, et al. Neutrophil-to-lymphocyte Ratio and Its Relation with Markers of Inflammation and Myocardial Necrosis in Patients with Acute Coronary Syndrome［J］. Med Arch, 2017,71(5):312-315.
［10］Tamhane UU, Aneja S, Montgomery D, et al. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome［J］. Am J Cardiol, 2008,102(6):653-657.
［11］Crea F, Libby P. Acute coronary syndromes: the way forward from mechanisms to precision treatment［J］. Circulation, 2017,136(12):1155-1166.
［12］Balta S, Celik T, Mikhailidis DP, et al. The relation between atherosclerosis and the neutrophil-lymphocyte ratio［J］. Clin Appl Thromb Hemost, 2016,22(5):405-411.
［13］Bhat T, Teli S, Rijal J, et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review［J］. Expert Rev Cardiovasc Ther, 2013,11(1):55-59.
［14］Mori M, Shuto K, Kosugi C, et al. An increase in the neutrophil-to-lymphocyte ratio during adjuvant chemotherapy indicates a poor prognosis in patients with stage II or III gastric cancer［J］. BMC Cancer, 2018, 18(1):1261.
［15］Kaya H, Ertas F, Islamoglu Y, et al. Association between neutrophil to lymphocyte ratio and severity of coronary artery disease［J］. Clin Appl Thromb Hemost, 2014, 20(1):50-54.
［16］Nunez J, Nunez E, Bodi V, et al. Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction［J］. Am J Cardiol, 2008,101(6):747-752.
［17］Azab B, Zaher M, Weiserbs KF, et al. Usefulness of neutrophil to lymphocyte ratio in predicting short- and long-term mortality after non-ST-elevation myocardial infarction［J］. Am J Cardiol, 2010,106(4):470-476.
［18］Gul M, Uyarel H, Ergelen M, et al. Predictive value of neutrophil to lymphocyte ratio in clinical outcomes of non-ST elevation myocardial infarction and unstable angina pectoris: a 3-year follow-up［J］. Clin Appl Thromb Hemost, 2014,20(4):378-384.
［19］Soylu K, Yuksel S, Gulel O, et al. The relationship of coronary flow to neutrophil/lymphocyte ratio in patients undergoing primary percutaneous coronary intervention［J］. J Thorac Dis, 2013,5(3):258-264.
［20］Yan SD, Liu XJ, Peng Y, et al. Admission Serum Calcium Levels Improve the GRACE Risk Score Prediction of Hospital Mortality in Patients With Acute Coronary Syndrome［J］. Clin Cardiol, 2016,39(9):516-523.
［21］Kundi H. The role of platelet-lymphocyte ratio in the severity of coronary artery disease assessed by the angiographic Gensini score［J］. Anatol J Cardiol, 2016,16(3):224.

[1]	LIAO Mengling, WANG Yan, LUO Jing, WANG Nuoyan, HUA Ling, ZHANG Yu, DENG Fei, YUAN Yue, ZHOU Jun, ZHOU Hong. Molecular mechanism of artesunate attenuates the release of proinflammatory cytokines from macrophages [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2023, 28(9): 969-978.
[2]	ZHAO Lingzhi, HE Yanjun, XIE Jianqin, YOU Chongge. Research progress on therapeutic role of recombinant human soluble thrombomodulin in atherosclerosis [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2023, 28(7): 832-840.
[3]	LIANG Hongyu, ZHANG Hailin, YIN Huanxin, CHEN Fan, LU Junlin, ZHU Caihong, HU Wei, ZHOU Renpeng. Effects of 2-APB in skin wound healing in mice through down-regulation of TRPM7 [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(7): 747-753.
[4]	MAO Shuying, JIN Wei, FU Sisi, LIU Keanqi, ZHOU Zhihao, WANG Guangji, LIANG Yan. Oral lienal peptides improve ammonia-induced coughing and inflammation in mice [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(6): 601-607.
[5]	JIN Yiyi, ZHOU Keting, YANG Chengcheng, XU Ping, ZHU Suyan. Osthole attenuates diabetes-induced renal injury by regulating NF-κB and p38/MAPK pathway mediated inflammatory responses [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(6): 622-631.
[6]	CHANG Shufu . Progress of medical treatment of coronary heart disease [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(4): 405-408.
[7]	WEI Jifang, YUE Hongmei, LIU Nanyu, SONG Peipei, XIE Yingying, WANG Jiaqi, WEI Yaqian. Research progress on the relationship between thyroid hormone and idiopathic pulmonary fibrosis [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(3): 307-313.
[8]	CHEN Yu, GU Bing, LI Huanan. Modulating gut miocrobiota: a new strategy in the treatment of gout [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(11): 1307-1314.
[9]	CHEN Yugang, TU Yanqiong, WANG Congqing, CHEN Juan, ZHANG Bohong. Network pharmacology and molecular docking to discuss the mechanism of Jinhutongdan prescription in the treatment of cholelithiasis and experimental verification [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(10): 1090-1098.
[10]	LI Ying, YAO Wei, WANG Meng, YU Zhihong, GONG Yuanqi, LAN Haibing, QI Xiefei. Experimental study of irisin alleviates house dust mite-induced airway epithelial cells inflammation and apoptosis via the NF-κB and JNK signaling pathways [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(10): 1106-1112.
[11]	WU Lin, HAO Yingxiang, ZHANG Lei, ZHANG Tianxue, GAO Mingjing, LENG Yufang. Paricalcitol attenuates intestinal ischemia-reperfusion injury in mice through HMGB1/TLR4/NF-κB signaling pathway [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2022, 27(1): 1-7.
[12]	WANG Rui, PAN Jinjin, LI Hua, YUAN Yuhui. Research progress of melatonin on pulmonary hypertension [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2021, 26(4): 444-448.
[13]	ZHANG Na, TANG Futian. Protective effect and mechanism of lycium barbarum polysaccharides on diabetic renal injury [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2021, 26(11): 1237-1243.
[14]	LI Jiadan，LU Chen. Synergistic effects of Cortex Mori alkaloids combined with Simvastatin in rats with hyperlipidaemia [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2020, 25(3): 278-284.
[15]	SONG Shanshan, YANG Yang, HE Jing, TANG Junfeng. Regulatory effect and mechanism of ginsenoside Rg1 on oxidative stress and inflammation in preeclampsia rats [J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2020, 25(10): 1088-1096.