Can lymphocyte to monocyte ratio be used as a predictor of atherosclerotic carotid plaques in elderly adults?

Introduction: The lymphocyte/ monocyte ratio(LMR), a novel marker of inflammation, has been accepted as a predictor for atherosclerosis. However, the relationship between LMR and carotid atherosclerotic stenosis in older healthy adults remains undefined. Aim: The aim of our study was to determine retrospectively the association of LMR with carotid stenosis, evaluated by carotid artery doppler ultrasonography. Materials and Methods: Our study included 102 patients, aged ≥ 65 years,hospitalized in our clinic from January 2011 to December 2017. Blood samples were taken from all of the patients to determine the levels of white blood cell subtypes. LMR was calculated as the ratio of lymphocyte count to monocyte count. Patients also underwent carotid artery doppler ultrasonography to define the presence of carotid stenosis. Results: After dividing the patient group into two subgroups according to carotid stenosis, the patients with severe stenosis( carotid stenosis> 50% )(n=42) had lower lymphocyte count and LMR value but higher monocyte count. Then the patient group with carotid stenosis> 50% were divided into two subgroups again. While a statistically significant difference was found between the LMR values ​​of these 3 groups, this difference was in favor of the first group(carotis stenosis ˂50%). The optimum cut-off LMR values was determined as 2.49 with a sensitivity of 72.6% and a specificity of 80.7%. Conclusion: Lower levels of LMR can be used as a strong predictor of the presence of severe carotid stenosis in elderly adults.