Evaluation of the Neutrophil-lymphocyte Ratio and Mean Platelet Volume in Hypertensive Patients with Coronary Artery Ectasia

Abstract

Introduction: Coronary artery ectasia (CAE) is associated with increased morbidity and mortality, and is known to also be associated with atherosclerosis. CAE is considered a variant of coronary artery disease, and is more common in patients with hypertension. We aimed to evaluate the neutrophil-lymphocyte ratio (NLR) and mean platelet volume (MPV) in hypertensive patients with CAE. Patients and Methods: The study was designed retrospectively in the cardiology unit of Bolu Abant Izzet Baysal University Medical Faculty Hospital between January 2017 and October 2019. A total of 7287 coronary angiographies were retrospectively analyzed to detect the incidence of ischemic heart disease. Diagnosis of CAE was made visually by two cardiologists who were blinded to the study aims. All included patients had a diagnosis of hypertension. After appropriate exclusions, hypertensive patients were divided into CAE and normal coronary artery groups, and the laboratory parameters of the two groups were compared. Results: The neutrophil counts [4.2 (2.4-8.6) vs. 4.2 (2.0-6.7) u/mm3 , p= 0.015], red cell distribution width [15.7 (12.8-21.6) vs. 15.3 (13.2-18.6) %, p= 0.002], platelet distribution width [17.9 (15.5-23.0) vs. 17.5 (15.9-20.8) %, p= 0.001], NLR [2.1 (0.7-12.8) vs. 1.9 (0.8-4.5), p< 0.001], platelet-lymphocyte ratio [109.8 (63.0-321.8) vs. 100.9 (34.7-223.6), p= 0.001], MPV (8.4 ± 1.4 vs. 7.9 ± 1.0 fL, p< 0.001), and plateletcrit (0.19 ± 0.05 vs. 0.18 ± 0.4 %, p= 0.007) were significantly higher, and the lymphocytes counts [2.1 (0.5-4.2) vs. 2.2 (1.1-6.7) u/mm3 , p= 0.013] were significantly lower in hypertensive patients with CAE than in those without. Conclusion: Hemogram parameters could be useful biomarkers for determining a thrombotic state and inflammatory response in hypertensive patients with CAE.

Keywords

• Coronary artery ectasia
• hypertension
• inflammation
• mean platelet volume
• neutrophil-lymphocyte ratio

Koroner Arter Ektazi Olan Hipertansif Hastalarda Nötrofil-Lenfosit Oranının ve Ortalama Trombosit Hacminin Değerlendirilmesi

Abstract

Giriş: Artmış morbidite ve mortalite ile ilişkili olan koroner arter ektazi (KAE), ateroskleroz ile ilişkilidir ve koroner arter hastalığının bir varyantı olarak kabul edilir. KAE hipertansiyonu olan hastalarda daha yaygındır. Bu çalışmada, hipertansif KAH olan hastalarda nötrofil-lenfosit oranını (NLR) ve ortalama trombosit hacmini (MPV) değerlendirmek amaçlanmıştır. Hastalar ve Yöntem: Çalışma Ocak 2017-Ekim 2019 tarihleri arasında Bolu Abant İzzet Baysal Üniversitesi Tıp Fakültesi Hastanesi kardiyoloji ünitesinde retrospektif olarak tasarlandı. Çalışmada 7287 koroner anjiyografi iskemik kalp hastalığını saptamak için retrospektif olarak incelendi. KAE tanısı görsel olarak iki kör kardiyolog tarafından konuldu. Çalışmaya dahil edilen tüm hastalarda hipertansiyon tanısı vardı. Uygun dışlamalar sonrasında hipertansif hastalar KAE ve normal koroner arter gruplarına ayrıldı. Bu iki grubun laboratuvar parametreleri karşılaştırıldı. Bulgular: Nötrofil sayısı [4.2 (2.4-8.6) vs. 4.2 (2.0-6.7) u/mm3 , p= 0.015], RDW [15.7 (12.8-21.6) vs. 15.3 (13.2-18.6) %, p= 0.002], PDW [17.9 (15.5-23.0) vs. 17.5 (15.9-20.8) %, p= 0.001], NLR [2.1 (0.7-12.8) vs. 1.9 (0.8-4.5), p< 0.001], PLR [109.8 (63.0-321.8) vs. 100.9 (34.7-223.6), p= 0.001], MPV (8.4 ± 1.4 vs. 7.9 ± 1.0 fL, p< 0.001) ve PCT (0.19 ± 0.05 vs. 0.18 ± 0.4 %, p= 0.007) KAE olan hipertansif hastalarda anlamlı olarak daha yüksekti. KAE olan hipertansif hastalarda lenfosit sayısı [2.1 (0.5-4.2) vs. 2.2 (1.1-6.7) u/mm3 , p= 0.013] anlamlı derecede düşüktü. Sonuç: Hemogram parametreleri, KAE olan hipertansif hastalarda trombotik bir durumun ve inflamatuvar yanıtın belirlenmesinde bir biyobelirteç olarak daha yararlı olabilir.

Keywords

• Hipertansiyon
• inflamasyon
• koroner arter ektazi
• nötrofil-lenfosit oranı
• ortalama trombosit hacmi

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