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

Authors : Bedrettin BOYRAZ, Ferit Onur MUTLUER, Dursun TOPAL, Mehmet DEMİR, Tezcan PEKER, Mustafa YILMAZ, Alkame AKGÜMÜŞ, Erhan TENEKECİOĞLU

Pages : 53-61

Doi:10.18621/eurj.447449

View : 43 | Download : 9

Publication Date : 2020-01-04

Article Type : Research Paper

Abstract :Objectives: Atherosclerosis represents an active inflammation that leukocytes play a major role. Neutrophil-lymphocyte ratio insert ignore into journalissuearticles values(NLR); has been shown as an indicator of systemic inflammation. Our aim was to evaluate inflammatory markers in obstructive coronary artery disease insert ignore into journalissuearticles values(CAD); and cardiac syndrome X insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(hs-CRP); was increased in CAD group and CSX group compared to the control group insert ignore into journalissuearticles values( p < 0.001);; however it was comparable between CAD and CSX groups insert ignore into journalissuearticles values( 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 insert ignore into journalissuearticles values(r = 0.43, p < 0.001);, and Gensini score insert ignore into journalissuearticles values(r = 0.54, p < 0.001);. NLR was also linearly correlated with Gensini score insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values( 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 insert ignore into journalissuearticles values( p < 0.001);. When cut-off value was taken as 9.5 insert ignore into journalissuearticles values(×10 9 /L); for white blood cell insert ignore into journalissuearticles values(WBC);, WBC values attained 58.8% sensitivity and 34.3% specificity insert ignore into journalissuearticles values( 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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