Differences in the Neutrophil-to-Lymphocyte Ratio Between Patients With Chronic and Acute Coronary Syndromes at Hung Vuong Gia Lai Hospital

Background and Objective: Coronary artery disease (CAD) is a global health issue, contributing significantly to morbidity and mortality rates. The inflammatory response plays a central role in the pathogenesis of atherosclerosis and acute coronary events. The neutrophil-to-lymphocyte ratio (NLR) is a simple, highly accessible inflammatory marker reflecting immunological imbalance. In Vietnam, studies regarding NLR are still limited. This study was conducted to describe the differences in the NLR between patients with chronic coronary syndrome (CCS) and acute coronary syndrome (ACS) and to evaluate the correlation between the NLR and left ventricular ejection fraction (LVEF), high-sensitivity Troponin T (hs-Troponin T), low-density lipoprotein cholesterol (LDL-C), and the severity of coronary artery lesions in these two groups. Materials and Methods: A cross-sectional descriptive study was conducted on 80 patients diagnosed with CAD (including CCS and ACS) who were indicated for coronary angiography at Hung Vuong Gia Lai Hospital. Clinical and subclinical data were collected and statistically analyzed using SPSS version 20.0, with a significance level of p < 0.05. Results: The mean age of the study population was 64.3 ± 10.6 years, and males accounted for 48%. Patients with ACS and CCS constituted 61.3% and 38.8%, respectively. The ACS group had a significantly higher prevalence of risk factors (hypertension, diabetes, dyslipidemia) and elevated LDL-C levels compared to the CCS group (LDL-C: 3.4 ± 1.1 mmol/L vs. 3.0 ± 0.8 mmol/L, p < 0.05). Regarding leukocyte inflammatory indices, the absolute neutrophil count in the ACS group was higher (11.3 ± 3.9 G/L vs. 8.4 ± 2.7 G/L), whereas the lymphocyte count was lower (1.9 ± 0.8 G/L vs. 2.5 ± 0.7 G/L), resulting in a significantly higher NLR in the ACS group compared to the CCS group (5.3 (4.6-7.8) vs. 3.7 (3.3-6.1), p < 0.05). In the ACS group, the NLR was positively correlated with hs-Troponin T levels (r = 0.42, p < 0.05) and the number of affected coronary vessels (r = 0.305, p < 0.05). With a cutoff value of NLR = 4.7, the ability to predict multivessel disease in the ACS group achieved an area under the curve (AUC) of 0.708 (sensitivity 87.5%, specificity 52.9%, p = 0.18). Conversely, in the CCS group, there was no significant correlation between the NLR and hs-Troponin T levels or the number of affected coronary vessels (p > 0.05). Conclusions: The NLR is significantly elevated in patients with acute coronary syndrome compared to those with chronic coronary syndrome. In the acute phase, the NLR demonstrates a positive correlation with the extent of myocardial necrosis (hs-Troponin T) and the number of affected coronary vessels, thereby suggesting its predictive value for clinical disease severity.