Objectives: We investigated the relation between neutrophil to lymphocyte ratio (N/L) and the extent, severity, and complexity of coronary artery disease (CAD) and myocardial perfusion.Study design: One hundred and fifty-one patients who underwent coronary angiography with stable angina pectoris (SAP) (n=93) or acute coronary syndrome (ACS) (n=58) were included in the study.Blood samples were drawn before Custom Shaped Wood Sign coronary angiography.
Gensini and SYNTAX scores and myocardial blush grade (MBG) were assessed.Results: Neutrophil counts were 4.4+-1.
4 and 5.0+-1.6 in the SAP and ACS groups (p=0.
018), whereas lymphocyte counts were 2.2+-0.7 and 2.
1+-0.7, respectively (p=0.104).
N/L was 2.2+-1.2 in the SAP and 2.
6+-1.0 in the ACS (p=0.002) groups.
In patients with SAP, N/L was significantly correlated with Gensini and SYNTAX scores (Gensini score r=0.32, p=0.002; SYNTAX score r=0.
36, p=0.000), but there was no significant correlation between Grommet N/L and MBG.In the ACS group, N/L had a more powerful association with both Gensini and SYNTAX scores (Gensini r=0.
42, p=0.001; SYNTAX r=0.51, p=0.
000).N/L was negatively correlated with MBG in ACS patients (r= -0.48, p=0.
000).Significant correlations persisted both in the SAP and ACS groups after correcting for age, diabetes, hyperlipidemia, and statin use; however, the associations were weaker.Cut-off N/L to predict moderate to severe CAD according to SYNTAX score was 2.
26, with 72% sensitivity and 71% specificity (area under the curve [AUC]: 0.772, 95% confidence interval [CI] 0.679-0.
865, p<0.001).Conclusion: N/L is associated with severe, extensive and complex CAD and may be used to predict moderate to severe involvement in patients with CAD.