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Impact of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio on 5-Year Clinical Outcomes of Patients with Stable Coronary Artery Disease Undergoing Elective Percutaneous Coronary Intervention

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Abstract

The prognostic role of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with stable coronary artery disease (CAD) is still unclear. We enrolled 500 patients undergoing elective percutaneous coronary intervention (PCI). Blood samples were drawn prior to PCI for NLR and PLR calculation. Major adverse clinical events (MACE), which included death, myocardial infarction (MI), and target vessel revascularization (TVR), were recorded up to 5 years. Patients in the higher tertile of NLR presented higher Kaplan–Meier estimates of MACE (26.0% vs. 16.9% in tertile 2 vs. 14.3% in tertile 1; p = 0.042) and death (12.0% vs 6.9% in tertile 2 vs. 4.6% in tertile 1; p = 0.040), whereas there were no significant differences in the estimates of MI and TVR. NLR in the higher tertile was an independent predictor of MACE (HR 1.65, 95% CI 1.07–2.55, p = 0.024). No significant difference was observed across tertiles of PLR. Unlike PLR, elevated pre-procedural NLR is associated with an increased risk of 5-year clinical adverse events.

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Authors and Affiliations

  1. Department of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Via Álvaro del Portillo, 200, 00128, Rome, Italy

    Edoardo Bressi, Fabio Mangiacapra, Elisabetta Ricottini, Ilaria Cavallari, Iginio Colaiori, Giuseppe Di Gioia, Antonio Creta, Marialessia Capuano, Michele Mattia Viscusi & Germano Di Sciascio

Authors
  1. Edoardo Bressi
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  2. Fabio Mangiacapra
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  3. Elisabetta Ricottini
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  4. Ilaria Cavallari
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  5. Iginio Colaiori
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  6. Giuseppe Di Gioia
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  7. Antonio Creta
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  8. Marialessia Capuano
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  9. Michele Mattia Viscusi
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  10. Germano Di Sciascio
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Correspondence to Fabio Mangiacapra.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Associate Editor Craig Stolen oversaw the review of this article

Key Messages

The results of our study suggest that neutrophil-to-lymphocyte ratio (NLR), a simple and easily available inflammatory marker, may be used for risk stratification of patients undergoing elective percutaneous coronary revascularization, in that elevated pre-procedural values of NLR may help identify those patients at higher risk of future clinical adverse events. These patients may potentially benefit from tailored therapeutic strategies, such as more aggressive anti-inflammatory and anti-thrombotic treatment. This hypothesis warrants further investigation.

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Bressi, E., Mangiacapra, F., Ricottini, E. et al. Impact of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio on 5-Year Clinical Outcomes of Patients with Stable Coronary Artery Disease Undergoing Elective Percutaneous Coronary Intervention. J. of Cardiovasc. Trans. Res. 11, 517–523 (2018). https://doi.org/10.1007/s12265-018-9829-6

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  • DOI: https://doi.org/10.1007/s12265-018-9829-6

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