Relationship of Hematological Indices with Angiographic Severity of Coronary Artery Disease and Short-term Outcomes in Patients Undergoing Coronary Angiography

A BSTRACT Background: Atherosclerosis is a systemic inflammatory disease in which hematological indices such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, red cell distribution width, and mean platelet volume have emerged as inexpensive markers of inflammatory activity. Their relationship with angiographic severity of coronary artery disease (CAD) and short-term outcomes remains incompletely characterized, particularly in Indian populations. Materials and Methods: This prospective, observational study enrolled 396 consecutive patients undergoing coronary angiography at a tertiary care center in North India. Preprocedural hematological profiles were obtained in all patients. Angiographic severity was assessed by vessel involvement and Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score. Short-term in-hospital outcomes including acute kidney injury (AKI), left ventricular failure, and procedural complications were recorded. Statistical analyses included Kruskal–Wallis, Mann–Whitney U , and Spearman correlation analyses for nonnormally distributed variables. Results: The mean age was 54.6 ± 10.4 years and 79.5% of patients were male. ST-elevation myocardial infarction (STEMI) was the most common diagnosis (28.0%), while three-vessel disease predominated (47.5%). NLR demonstrated a stepwise numerical increase from single-vessel to three-vessel disease, although this did not achieve statistical significance ( P = 0.244). NLR varied significantly across diagnostic categories ( P = 0.007), with highest values observed in non-STEMI. Patients developing AKI had significantly higher NLR values ( P = 0.043). However, none of the hematological indices correlated significantly with SYNTAX score. Conclusion: Hematological indices did not demonstrate significant association with angiographic complexity or SYNTAX score. Although NLR varied across clinical presentations and showed an unadjusted association with AKI, these findings should be interpreted cautiously pending validation in larger multicenter studies with multivariable adjustment.