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May 29, 2022Nepalese Heart JournalOpen Access

Relation of neutrophil-to-lymphocyte ratio with coronary artery disease severity in patients undergoing coronary angiography

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Key result

NLR over 3 predicts ~17-fold higher odds of severe CAD.

  • OR 17.36
  • 95% CI 6.77-44.49
  • P=0.001
  • n=147

Why the study?

Neutrophil-to-lymphocyte ratio (NLR) has emerged as a new inflammatory marker for identifying coronary artery disease (CAD), but its correlation with CAD severity and suitable predictive cut-off values were not established.

Does neutrophil-to-lymphocyte ratio correlate with coronary artery disease severity in patients undergoing coronary angiography?

Population

147 patients undergoing coronary angiography for angina with ischemic ECG changes

Comparison

NLR levels across low, intermediate, and high SYNTAX score groups

Design

Cross-sectional study

Authors

BNBikash NepalJGJeet Prasad GhimireBKBiplave Karki

Discussion

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Member takes

Overview

NLR >3 may flag severe CAD on angiography; leaves open incremental value in prospective risk models.

Study Design

Type

Cross-Sectional (n=147)

Multicenter

No

Structured PICO

Does neutrophil-to-lymphocyte ratio correlate with coronary artery disease severity in patients undergoing coronary angiography?

P
Population
147 patients (mean age 61.3 years, 32% female) undergoing coronary angiography for angina with ischemic ECG changes or biomarker evidence of myocardial injury.
E
Exposure
Neutrophil-to-lymphocyte ratio (NLR) measurement
O
Outcome
Coronary artery disease severity assessed by SYNTAX score and presence of CADsurrogate

Main Result

Odds Ratio: 17.36 (95% CI 6.77–44.49)

p-value: p=0.001

An elevated neutrophil-to-lymphocyte ratio (>3) is strongly associated with high SYNTAX scores and may serve as a simple, accessible biomarker for predicting severe coronary artery disease.

Limitations

  • Small sample size
  • Restricted to a single center, not representing the whole Nepalese population
  • Lack of outcome-related data
  • Did not assess cardiovascular risk factors such as carotid intima media thickness, ankle-brachial index, or other inflammatory markers like CRP

Cite This Study

Nepal et al. (2022) conducted a cross-sectional in Coronary artery disease severity (n=147). Neutrophil-to-lymphocyte ratio (NLR) > 3 vs. Lower NLR was evaluated on High SYNTAX score (>32) (OR 17.36, 95% CI 6.77-44.49, p=0.001). A neutrophil-to-lymphocyte ratio greater than 3 independently predicted severe coronary artery disease, defined as a high SYNTAX score, with an odds ratio of 17.36.

synapsesocial.com/papers/6ab1ca3ec31b79672685bbd7https://doi.org/10.3126/njh.v19i1.45274
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Neutrophil to Lymphocyte Ratio Is Associated With the Severity of Coronary Artery Disease in Patients With ST-Segment Elevation Myocardial Infarction2012 · 73 citations
  2. 2Inflammation in Atherosclerosis2009 · 2,236 citations
  3. 3Is Neutrophil-to-Lymphocyte Ratio a Predictor of Coronary Artery Disease in Western Indians?2017 · 45 citations
  4. 4Which White Blood Cell Subtypes Predict Increased Cardiovascular Risk?2005 · 980 citations