Assessment of inflammatory parameters in obstructive coronary artery disease and cardiac syndrome X: an evolving value of neutrophil-lymphocyte ratio

Year 2020, Volume: 6 Issue: 1, 53 - 61, 04.01.2020

Bedrettin Boyraz Ferit Onur Mutluer Dursun Topal Mehmet Demir Tezcan Peker Mustafa Yılmaz Alkame Akgümüş Erhan Tenekecioğlu

https://doi.org/10.18621/eurj.447449

Abstract

Objectives:
Atherosclerosis represents an active inflammation that
leukocytes play a major role. Neutrophil-lymphocyte ratio (NLR) has been shown
as an indicator of systemic inflammation. Our aim was to evaluate inflammatory
markers in obstructive coronary artery disease (CAD) and cardiac syndrome X
(CSX) and to evaluate NLR in predicting CAD in patients with typical chest pain
and coronary risk factors.

Methods: Eighty patients with CSX, 80 patients with obstructive
CAD with unstable angina pectoris and a control group of 80 subjects were
recruited into the study. Hematologic and biochemical parameters were
investigated.

Results: High-sensitive C-reactive protein (hs-CRP) was
increased in CAD group and CSX group compared to the control group (p <
0.001); however it was comparable between CAD and CSX groups (p =
0.065). Mean NLR was higher in CAD group than CSX group and control group that
the lowest value was in the control group. In CAD group, hs-CRP was positively
correlated with NLR (r = 0.43, p < 0.001), and Gensini score (r =
0.54, p < 0.001). NLR was also linearly correlated with Gensini score
(r = 0.49, p < 0.001). In ROC curve analysis, for the NLR of 2.26, NLR
values attained 85.5% sensitivity and 43.9% specificity (p < 0.001).
When cut-off value was taken as 3.05 mg/dL for CRP, CRP values attained 78.7%
sensitivity and 43.6% specificity (p < 0.001). When cut-off value was
taken as 9.5 (×10⁹ /L) for white blood cell (WBC), WBC values
attained 58.8% sensitivity and 34.3% specificity (p < 0.001).

Conclusions: NLR seems to be
usefull in prediction of obstructive CAD and can be implemented in planning for
diagnostic procedures in patients with typical chest pain. Increased CRP, WBC
and NLR may give insight about main pathology of CSX. Despite absence of
obstructive narrowing in epicardial coronaries, it appears be salutary to treat
CSX due to the similar underlying pathophysiology with obstructive CAD. 

Keywords

obstructive coronary artery disease, cardiac syndrome X, neutrophil-lymphocyte ratio

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