Submitted: 20 Jan 2021
Accepted: 18 Jul 2021
ePublished: 25 Aug 2021
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J Cardiovasc Thorac Res. 2021;13(3): 216-221.
doi: 10.34172/jcvtr.2021.40
  Abstract View: 31
  PDF Download: 67

Original Article

Association of neutrophil to lymphocyte ratio (NLR) with angiographic SYNTAX score in patients with non-ST-Segment elevation acute coronary syndrome (NSTE-ACS)

Mehdi Maleki 1 ORCID logo, Arezou Tajlil 1, Ahmad Separham 1, Bahram Sohrabi 1, Leili Pourafkari 2, Neda Roshanravan 1 ORCID logo, Naser Aslanabadi 1, Farima Najjarian 1, Sina Mashayekhi 1, Samad Ghaffari 1* ORCID logo

1 Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
2 Catholic Health System, Sisters of Charity Hospital, University at Buffalo, NY, USA
*Corresponding Author: Samad Ghaffari, Email: ghafaris@gmail.com


Introduction: Considering the role of inflammation in pathogenesis of atherosclerosis, we aimed to investigate the association of presentation neutrophil to lymphocyte ratio (NLR) with complexity of coronary artery lesions determined by SYNTAX score in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS).

Methods: From March 2018 to March 2019, we recruited 202 consecutive patients, who were hospitalized for NSTE-ACS and had undergone percutaneous coronary intervention in our hospital. The association of presentation NLR with SYNTAX score was determined in univariate and multivariate linear regression analysis.

Results: Higher NLR was significantly associated with higher SYNTAX score (beta= 0.162, P=0.021). In addition, older age, having hypertension, higher TIMI score, and lower ejection fraction on echocardiographic examination were significantly associated with higher SYNTAX score. TIMI score had the largest beta coefficient among the studied variables (TIMI score beta=0.302, P<0.001). In two separate multivariate linear regression models, we assessed the unique contribution of NLR in predicting SYNTAX score in patients with NSTE-ACS. In the first model, NLR was significantly contributed to predicting SYNTAX score after adjustment for age, sex, and hypertension as covariates available on patient presentation (beta=0.142, P=0.040). In the second model, NLR was not an independent predictor of SYNTAX score after adjustment for TIMI score (beta=0.121, P=0.076).

Conclusion: In NSTE-ACS, presentation NLR is associated with SYNTAX score. However, NLR does not contribute significantly to the prediction of SYNTAX score after adjustment for TIMI score. TIMI risk score might be a better predictor of the SYNTAX score in comparison to NLR.

Keywords: Acute Coronary Syndrome, Neutrophil, Lymphocyte, NLR, Inflammation, Coronary Artery Diseases, SYNTAX Score, TIMI Risk Score, Myocardial Infarction

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