Neutrophil-lymphocyte ratio and severity ofatherosclerotic disease in stable coronary artery patientswith chronic total occlusion

Aim: Neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation that correlates with coronary artery disease. The Syntax score is an angiographic tool used in grading the complexity of coronary artery disease (CAD). The aim of this study is that NLR is associated with a greater CAD complexity in patients with stable angina pectoris with chronic total occlusion.Materials and Methods: A total of 495 patients who underwent coronary angiography and who had stable angina pectoris with chronic total occlusion in at least 1 vessel were included in the study. The syntax score was used to determine coronary complexity.Results: Patients with CAD were evaluated by grouping according to 2 different criteria as pointed in the European Society of Cardiology (ESC) revascularization guide. When the syntax S is divided into 3 groups (Syntax score 1-22, 23-32,> 32) according to their score values, or 2 groups (Syntax score 1-21 and> 22 or 1-31 and> 31) according to their Syntax score values, NLR was higher in high Syntax score groups than in low groups (p 32) or 2 groups according to Syntax score values (Syntax score 1-21 and >22 or 1-31 and >31) as pointed in ESC revascularization guideline, high Syntax score group having a higher NLR than low group (p

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1. Ross R. Atherosclerosis-an inflammatory disease, N Engl J Med 1999;340:115-26.
2. Libby P. Vascular biology of atherosclerosis: overview and state of the art. Am J Cardiol 2003;91:3-6.
3. Soehnlein O. Multiple roles for neutrophils in atherosclerosis. Circ Res 2012:110:875-88.
4. Gibson PH, Cuthbertson BH, Croal BL, et al. Usefulness of neutrophil/lymphocyte ratio as predictor of newonset atrial fibrillation after coronary artery bypass grafting. Am J Cardiol 2010;105:186-91.
5. Fowler AJ, Agha RA. Neutrophil/lymphocyte ratio is related to the severity of coronary artery disease and clinical outcome in patients undergoing angiographyThe growing versatility of NLR. Atherosclerosis. 2013;228:44-5.
6. Poludasu S, Cavusoglu E, Khan W, et al. Neutrophil to lymphocyte ratio as a predictor of long term mortality in African Americans undergoing percutaneous coronary intervention. Clin Cardiol 2009;32:6-10. 7. Vatankulu MA, Sonmez O, Ertas G. A new parameter predicting chronic total occlusion of coronary arteries: platelet distribution width. Angiology 2014;65:60-4.
8. Yamane M. Current percutaneous recanalization of coronary chronic total occlusion. Rev Esp Cardiol 2012;65:265-77.
9. Christofferson RD, Lehmann KG, Martin GV, et al. Effect of chronic total coronary occlusion on treatment strategy. Am J Cardiol 2005;95:1088-91.
10. Srinivas VS, Brooks MM, Detre KM, et al. Contemporary percutaneous coronary intervention versus balloon angioplasty for multivessel coronary artery disease: a comparison of the National Heart, Lung and Blood Institute Dynamic Registry and the Bypass Angioplasty Revascularization Investigation (BARI) study. Circulation 2002;106:1627-33.
11. Sianos G, Morel MA, Kappetein AP, et al. SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease. Euro Intervention. 2005;1:219-27.
12. Girasis C, Garg S, Räber L, et al. SYNTAX score and Clinical SYNTAX score as predictors of very longterm clinical outcomes in patients undergoing percutaneous coronary interventions: a substudy of SIRolimus-eluting stent compared with pacliTAXeleluting stent for coronary revascularization (SIRTAX) trial. Eur Heart J 2011;32:3115-27
13. Wijns W, Kolh P, Danchin N, et al. Guidelines on myocardial revascularization. Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS); European Association for Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J 2010;31:2501-5.
14. SYNTAX working group. SYNTAX score calculator. (www. syntaxscore.com) [Accessed April 2012].
15. Horne BD, Anderson JL, John JM, et al. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol 2005;45:1638-43.
16. Sahin DY, Elbasan Z, Gür M, et al. Neutrophil to lymphocyte ratio is associated with the severity of coronary artery disease in patients with ST-segment elevation myocardial infarction. Angiology 2013;61: 144-8.
17. Sönmez O, Ertaş G, Bacaksız A, et al. Relation of neutrophil-to-lymphocyte ratio with the presence and complexity of coronary artery disease: an observational study. Anadolu Kardiyol Derg 2013;13: 662-7.
18. Tanındı A, Erkan AF, Ekici B, et al. Neutrophil to lymphocyte ratio is associated with more extensive, severe and complex coronary artery disease and impaired myocardial perfusion. Turk Kardiyol Dern Ars 2014;42:125-30.
19. Papa A, Emdin M, Passino C, et al. Predictive value of elevated neutrophil lymphocyte ratio on cardiac mortality in patients with stable coronary artery disease. Clin Chim Acta 2008;395:27-31.
20. Akpek M, Kaya MG, Lam YY, et al. Relation of neutrophil/lymphocyte ratio to coronary flow to inhospital major adverse cardiac events in patients with ST-elevated myocardial ınfarction undergoing primary coronary ıntervention. Am J Cardiol 2012;110:621-7.
21. Tamhane UU, Aneja S, Montgomery D, et al. Association between admission neutrophil -to- lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 2008;102:653-7.
22. Furman MI, Gore JM, Anderson FA, et al. GRACE Investigators. Elevated leukocyte count and adverse hospital events in patients with acute coronary syndromes: findings from the Global Registry of Acute Coronary Events (GRACE). Am Heart J 2004;147:42-8.
23. Demir K, Avci A, Altunkeser BB, Yilmaz A, Keles F, Ersecgin A. The relationship between neutrophilto-lymphocyte ratio and coronary chronic total occlusions. BMC Cardiovasc Disord 2014;14:130.
24. Kaya A, Kurt M, Tanboga IH, et al. Relation of Neutrophil to Lymphocyte Ratio With the Presence and Severity of Stable Coronary Artery Disease. Clin Appl Thromb Hemost 2013;20:473-7.
25. Gillum RF, Mussolino ME, Madans JH. Counts of neutrophils, lymphocytes, and monocytes, causespecific mortality and coronary heart disease: the NHANES-I epidemiologic follow-up study. Ann Epidemiol 2005;15:266-71.
26. Muhmmed Suliman MA, Bahnacy Juma AA, Ali Almadhani AA, et al. Predictive value of neutrophil -tolymphocyte ratio in outcomes of patients with acute coronary syndrome. Arch Med Res 2010;41:618-22.
27. Kirtane AJ, Bui A, Murphy SA, et al. Association of peripheral neutrophilia with adverse angiographic outcomes in ST elevation myocardial infarction. Am J Cardiol 2004;93:532-6.
28. Zazula AD, Précoma-Neto D, Gomes AM, et al. An assessment of neutrophils/lymphocytes ratio in patients suspected of acute coronary syndrome. Arq Bras Cardiol 2008;90:31-6.
29. Okyay GU, Inal S, Onec K, et al. Neutrophil to lymphocyte ratio in evaluation of inflammation in patients with chronic kidney disease. Ren Fail 2013;35:29-36