Relationship between the neutrophil to HDL-C ratio and anatomical significance of coronary artery stenosis in patients with documented myocardial ischemia.

OBJECTIVE: Diagnostic workup of coronary artery disease (CAD) requires a stepwise approach, starting with detailed history-taking and ending with invasive coronary angiography (ICA) in some cases. The neutrophil to high-density lipoprotein cholesterol (HDL-C) ratio (NHR) is related to CAD. We assessed the association between the NHR and anatomical significance of coronary artery stenosis (CAS) in patients with documented ischemia. PATIENTS AND METHODS: The study enrolled 306 consecutive patients with documented myocardial ischemia on myocardial perfusion imaging (MPI). All patients underwent ICA. Patients with no visible stenosis (NVS) or minimal or mild CAS were compared with those with moderate or severe CAS. RESULTS: The study compared 85 patients with NVS or minimal or mild CAS (46.51% female) and 221 patients with moderate or severe CAS (31.58% female). In the latter group, hypertension and diabetes mellitus (DM) were more prevalent than in the former group (83.73% vs. 60.47%, p<0.001; 47.37% vs. 30.23%, p=0.005, respectively). A higher NHR (cut-off point of 103.2) was associated with moderate or severe CAS. CONCLUSIONS: Even when myocardial ischemia is demonstrated by MPI, NVS or minimal or mild CAS is still frequently diagnosed based on ICA. A lower NHR could be an inexpensive, non-invasive marker of the need for ICA.