The Relationship Between Neutrophil/Lymphocyte Ratio Before Coronary Angiography and Coronary Collateral Development

冠状动脉造影前中性粒细胞/淋巴细胞比值与冠状动脉侧支循环形成的关系

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Abstract

OBJECTIVE: The aim of this study was to determine the relationship between the neutrophil/lymphocyte ratio (NLR) measured before coronary angiography and coronary collateral (CC) development. METHOD: This retrospective descriptive study was carried out between January 2012 and June 2013 in the cardiology outpatient clinic of a university hospital in Aydın, with 165 patients who were diagnosed with acute coronary syndrome or stable angina pectoris and who had 95% or more stenosis in at least one coronary artery according to angiography. Coronary artery stenosis was determined by Gensini scoring. The classification of CC was performed by the Rentrop method, and patients were divided into two groups: Rentrop stages 0 and 1 (poor CC filling (group 1)) and Rentrop stages 2 and 3 (good CC filling (group 2)). The data were analyzed using appropriate statistical analyses. Multivariate logistic regression was used to determine the predictors of CC level, and receiver operating characteristic (ROC) curve analysis was performed to calculate the predictive value of predictors. RESULTS: When the groups were compared, the mean age (p=0.023), Gensini score (p<0.001), smoking status (p=0.012), creatinine level (p=0.032), and aspartate aminotransferase level (p=0.032) of the patients in group 1 were significantly lower than those in group 2, while their total cholesterol (p=0.006) and low-density lipoprotein (LDL) levels (p=0.020) were higher. Neutrophils (p=0.016) and NLR (p<0.001) were significantly higher in group 2 patients. A significant positive correlation was found between CC level and neutrophils (p=0.035) and NLR (p=0.011). In regression analysis, high NLR, high Gensini score, and smoking were predictors of good CC filling. According to ROC curve analysis, the sensitivity and specificity of NLR ≥3.53 at the time of presentation to the clinic for predicting good CC filling were 37.6% and 85%, respectively. CONCLUSION: This study showed that NLR was significantly associated with the development of good CC filling; as NLR increased, the development of good CC filling increased in patients.

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