Key result
Higher neutrophil-to-HDL-C ratio is linked to ~2-fold higher odds of CAD per SD.
Why the study?
The neutrophil-to-HDL-C ratio (NHR) was recently proposed as a potential biomarker of CAD, motivating evaluation of its association with the presence and angiographic severity of CAD.
Is a higher neutrophil-to-HDL-C ratio (NHR) associated with the presence and angiographic severity of coronary artery disease in symptomatic patients undergoing coronary angiography?
Cross-Sectional (n=250)
Coronary angiograms were analyzed by an experienced interventional cardiologist who was blinded to all laboratory and clinical information (except age and sex).
No
Is a higher neutrophil-to-HDL-C ratio (NHR) associated with the presence and angiographic severity of coronary artery disease in symptomatic patients undergoing coronary angiography?
In symptomatic patients undergoing coronary angiography, a higher neutrophil-to-HDL-C ratio is independently associated with both the presence of CAD and higher angiographic stenosis severity, though its standalone discriminative accuracy is modest.
Answers are grounded in this paper and cite their sources.
Higher NHR was associated with CAD presence and severity; leaves open its incremental value for risk stratification in symptomatic patients.
BACKGROUND: Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. Inflammation plays a central role in the pathogenesis of atherosclerosis, with neutrophils and high-density lipoprotein cholesterol (HDL-C) being key components. The neutrophil-to-HDL-C ratio (NHR) has recently been proposed as a potential biomarker of CAD. This study is aimed at evaluating the association of NHR with the presence and angiographic severity of CAD. METHODS: /μL) divided by HDL-C (mmol/L). Multivariable logistic regression and receiver operating characteristic (ROC) analyses were performed; the model adjusted for age, sex, smoking, body mass index, and blood pressure (Model III) was designated as the primary model, and a fully adjusted model (Model IV) served as a sensitivity analysis. RESULTS: The findings showed that patients with CAD had a significantly higher NHR than patients without CAD (3.9 ± 1.8 vs. 3.1 ± 1.28, p = 0.001). NHR increased across Gensini score tertiles (p = 0.04). In the primary adjusted model, each 1-SD increase in NHR was independently associated with CAD (OR = 2.01, 95% CI 1.28-3.14; p = 0.002) and a high Gensini score (OR = 1.56, 95% CI 1.14-2.12; p = 0.005). Bootstrap resampling (1000 replicates) confirmed the stability of these estimates. These findings were consistent in the fully adjusted model (OR = 2.31 and 1.62, respectively). NHR showed only modest discriminative ability for CAD (AUC = 0.638) and a high Gensini score (AUC = 0.620). CONCLUSION: NHR was independently associated with the presence and severity of CAD in patients referred for coronary angiography. However, its discriminative ability was modest, and its incremental value and prognostic utility require validation in independent prospective cohorts.
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Mohammadi et al. (2026) conducted a cross-sectional in Suspected coronary artery disease undergoing coronary angiography (n=250). Neutrophil-to-HDL-C ratio (NHR, per 1-SD increment of 1.71) vs. Symptomatic patients without significant coronary stenosis (<50% luminal stenosis, n=58) or lower NHR levels was evaluated on Presence of coronary artery disease (defined as >=50% luminal stenosis in one or more major coronary arteries) in the primary adjusted model (Model III) (OR 2.01, 95% CI 1.28-3.14, p=0.002). Each 1-SD increase in the neutrophil-to-HDL-C ratio was independently associated with higher odds of coronary artery disease, though discriminative ability was modest.
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