Open AccessNeutrophil-To-Lymphocyte Ratio Predicts Coronary Collateral Circulation in Multivessel Coronary Artery Disease
Author(s) -
Yasmine F. Siregar,
Zulfikri Mukhtar,
Ali Napiah Nasution,
Harris Hasan,
Ameilia Zuliyanti Siregar,
Cut Aryfa Andra
Publication year - 2020
Publication title -
aci (acta cardiologia indonesiana)
Language(s) - English
Resource type - Journals
eISSN - 2579-4345
pISSN - 2460-5700
DOI - 10.22146/jaci.v6i1.100
Subject(s) - medicine , receiver operating characteristic , cardiology , coronary artery disease , collateral circulation , logistic regression , neutrophil to lymphocyte ratio , likelihood ratios in diagnostic testing , lymphocyte
Background: Coronary collateral circulation (CCC) is an adaptive response to chronic myocardial ischemia. Patients with coronary stenosis develop varying degrees of collateral. Levels of inflammatory cells were suggested as potential determinants of collateral development. Neutrophil to lymphocyte (N/L) ratio has been proposed as a prognostic marker to determine systemic inflammatory response and the development of CCC. Our aim was to determine the relationship between N/L ratio and development of CCC in patients with coronary artery disease (CAD) with multivessel disease.Method:A total of 151 patients with multivessel disease were included in this study. Coronary collateral grades were classified according to Rentrop collateral grades as either poorly developed CCC (Rentrop grade 0-1) or well developed CCC (Rentrop grades 2-3). Factors significant at the p≤0.25 in the bivariate models were put into multiple logistic regressions. The receiver–operating characteristic (ROC) analysis were performed to determine the cutoff value of NLR in predicting poor CCC.Result: Of the 151 CAD patients in this study, 76 patients had poorly developed CCC and 75 patients had well developed CCC. Poorly developed CCC had significantly higher N/L ratio than well developed CCC (2.25±1.189 vs. 3.03±1.527, p 1.99 was independently associated with impairment in coronary collateralization. This value had a sensitivity of 78.9% and specificity of 52%.