The Korean journal of internal medicine

  • 제31권6호
  • /
  • Pages.1093-1100
  • /
  • 2016
  • /
  • 1226-3303(pISSN)
  • /
  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지
DOI QR코드

DOI QR Code

Blood count parameters can predict the severity of coronary artery disease

  • Uysal, Hilal Bektas (Department of Internal Medicine, Adnan Menderes University School of Medicine) ;
  • Dagli, Bekir (Department of Emergency, Adnan Menderes University School of Medicine) ;
  • Akgullu, Cagdas (Department of Cardiology, Adnan Menderes University School of Medicine) ;
  • Avcil, Mucahit (Department of Emergency, Adnan Menderes University School of Medicine) ;
  • Zencir, Cemil (Department of Cardiology, Adnan Menderes University School of Medicine) ;
  • Ayhan, Mediha (Department of Endocrinology, Adnan Menderes University School of Medicine) ;
  • Sonmez, Hulki Meltem (Department of Internal Medicine, Adnan Menderes University School of Medicine)
  • 투고 : 2015.07.01
  • 심사 : 2015.09.22
  • 발행 : 2016.11.01
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: Because of the inflammatory nature of coronary artery disease (CAD), both platelets and white blood cells have been investigated for years. The aim of this study was to investigate the relationships between some prominently hematologic blood count parameters (mean platelet volume [MPV], neutrophil to lymphocyte ratio [NLR]) and the severity of CAD by using Gensini scores. Methods: A total of 194 patients, who had undergone coronary angiography, enrolled in this study. The control group consisted of 42 patients who had normal coronary arteries. Remaining CAD patients were divided into two groups according to their Gensini scores. Results: NLR and MPV were higher in the severe atherosclerosis group compared with the mild atherosclerosis group (p = 0.007, p = 0.005, respectively). The Gensini score showed significant correlations with NLR (r = 0.20, p = 0.011), MPV (r = 0.23, p = 0.004) and high density lipoprotein cholesterol (r = -0.161, p = 0.047). Using a cut-off level of 2.54, NLR predicted severe atherosclerosis with a sensitivity of 74% and specificity of 53% (area under curve [AUC], 0.627; 95% confidence interval [CI], 0.545 to 0.704; p = 0.004). MPV values above 10.4 predicted severe atherosclerosis with a sensitivity of 39% and specificity of 90% (AUC, 0.631; 95% CI, 0.549 to 0.708; p = 0.003). In the multiple logistic regression analysis, high levels of NLR (odds ratio [OR], 1.450; 95% CI, 1.080 to 1.945; p = 0.013) and MPV (OR, 1.622; 95% CI, 1.147 to 2.295; p = 0.006) were found to be independent predictors of severe atherosclerosis. Conclusions: Our study suggests that both NLR and MPV are predictors of severe atherosclerosis and may be used for the prediction and identification of cardiac risks in CAD patients.

키워드

참고문헌

  1. Ross R. Atherosclerosis: an inflammatory disease. N Engl J Med 1999;340:115-126. https://doi.org/10.1056/NEJM199901143400207
  2. Gillum RF, Mussolino ME, Madans JH. Counts of neutrophils, lymphocytes, and monocytes, cause-specific mortality and coronary heart disease: the NHANES-I epidemiologic follow-up study. Ann Epidemiol 2005;15:266-271. https://doi.org/10.1016/j.annepidem.2004.08.009
  3. Horne BD, Anderson JL, John JM, et al. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol 2005;45:1638-1643. https://doi.org/10.1016/j.jacc.2005.02.054
  4. Kawaguchi H, Mori T, Kawano T, Kono S, Sasaki J, Arakawa K. Band neutrophil count and the presence and severity of coronary atherosclerosis. Am Heart J 1996;132(1 Pt 1):9-12. https://doi.org/10.1016/S0002-8703(96)90384-1
  5. Duffy BK, Gurm HS, Rajagopal V, Gupta R, Ellis SG, Bhatt DL. Usefulness of an elevated neutrophil to lymphocyte ratio in predicting long-term mortality after percutaneous coronary intervention. Am J Cardiol 2006;97:993-996. https://doi.org/10.1016/j.amjcard.2005.10.034
  6. Papa A, Emdin M, Passino C, Michelassi C, Battaglia D, Cocci F. Predictive value of elevated neutrophil-lymphocyte ratio on cardiac mortality in patients with stable coronary artery disease. Clin Chim Acta 2008;395:27-31. https://doi.org/10.1016/j.cca.2008.04.019
  7. Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 2008;102:653-657. https://doi.org/10.1016/j.amjcard.2008.05.006
  8. Massberg S, Schulz C, Gawaz M. Role of platelets in the pathophysiology of acute coronary syndrome. Semin Vasc Med 2003;3:147-162. https://doi.org/10.1055/s-2003-40673
  9. Tsiara S, Elisaf M, Jagroop IA, Mikhailidis DP. Platelets as predictors of vascular risk: is there a practical index of platelet activity? Clin Appl Thromb Hemost 2003;9:177-190. https://doi.org/10.1177/107602960300900301
  10. Lippi G, Filippozzi L, Salvagno GL, et al. Increased mean platelet volume in patients with acute coronary syndromes. Arch Pathol Lab Med 2009;133:1441-1443.
  11. Jagroop IA, Mikhailidis DP. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol 2003;120:169-170. https://doi.org/10.1046/j.1365-2141.2003.03983_4.x
  12. Huang G, Zhao JL, Du H, Lan XB, Yin YH. Coronary score adds prognostic information for patients with acute coronary syndrome. Circ J 2010;74:490-495. https://doi.org/10.1253/circj.CJ-09-0637
  13. Levey AS, Greene T, Kusek JW, Beck GJ. A simplified equation to predict glomerular filtration rate from serum creatinine. J Am Soc Nephrol 2000;11:155A.
  14. Ryan TJ, Faxon DP, Gunnar RM, et al. Guidelines for percutaneous transluminal coronary angioplasty: a report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee on Percutaneous Transluminal Coronary Angioplasty). Circulation 1988;78:486-502. https://doi.org/10.1161/01.CIR.78.2.486
  15. Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol 1983;51:606. https://doi.org/10.1016/S0002-9149(83)80105-2
  16. Oishi Y, Wakatsuki T, Nishikado A, Oki T, Ito S. Circulating adhesion molecules and severity of coronary atherosclerosis. Coron Artery Dis 2000;11:77-81. https://doi.org/10.1097/00019501-200002000-00013
  17. Kaya H, Ertas F, Soydinc MS. Association between neutrophil to lymphocyte ratio and severity of coronary artery disease. Clin Appl Thromb Hemost 2014;20:221. https://doi.org/10.1177/1076029613499821
  18. Sonmez O, Ertas G, Bacaksiz A, et al. Relation of neutrophil-to-lymphocyte ratio with the presence and complexity of coronary artery disease: an observational study. Anadolu Kardiyol Derg 2013;13:662-667.
  19. Baetta R, Corsini A. Role of polymorphonuclear neutrophils in atherosclerosis: current state and future perspectives. Atherosclerosis 2010;210:1-13. https://doi.org/10.1016/j.atherosclerosis.2009.10.028
  20. Madjid M, Awan I, Willerson JT, Casscells SW. Leukocyte count and coronary heart disease: implications for risk assessment. J Am Coll Cardiol 2004;44:1945-1956. https://doi.org/10.1016/j.jacc.2004.07.056
  21. Ates AH, Canpolat U, Yorgun H, et al. Total white blood cell count is associated with the presence, severity and extent of coronary atherosclerosis detected by dual-source multislice computed tomographic coronary angiography. Cardiol J 2011;18:371-377.
  22. Ommen SR, Hodge DO, Rodeheffer RJ, McGregor CG, Thomson SP, Gibbons RJ. Predictive power of the relative lymphocyte concentration in patients with advanced heart failure. Circulation 1998;97:19-22. https://doi.org/10.1161/01.CIR.97.1.19
  23. Azab B, Zaher M, Weiserbs KF, et al. Usefulness of neutrophil to lymphocyte ratio in predicting short- and long-term mortality after non-ST-elevation myocardial infarction. Am J Cardiol 2010;106:470-476. https://doi.org/10.1016/j.amjcard.2010.03.062
  24. Gibson PH, Croal BL, Cuthbertson BH, et al. Preoperative neutrophil-lymphocyte ratio and outcome from coronary artery bypass grafting. Am Heart J 2007;154:995-1002. https://doi.org/10.1016/j.ahj.2007.06.043
  25. Kalay N, Dogdu O, Koc F, et al. Hematologic parameters and angiographic progression of coronary atherosclerosis. Angiology 2012;63:213-217. https://doi.org/10.1177/0003319711412763
  26. Drakopoulou M, Toutouzas K, Stefanadi E, Tsiamis E, Tousoulis D, Stefanadis C. Association of inflammatory markers with angiographic severity and extent of coronary artery disease. Atherosclerosis 2009;206:335-339. https://doi.org/10.1016/j.atherosclerosis.2009.01.041
  27. De Luca G, Santagostino M, Secco GG, et al. Mean platelet volume and the extent of coronary artery disease: results from a large prospective study. Atherosclerosis 2009;206:292-297. https://doi.org/10.1016/j.atherosclerosis.2009.02.008
  28. Tavil Y, Sen N, Yazici HU, Hizal F, Abaci A, Cengel A. Mean platelet volume in patients with metabolic syndrome and its relationship with coronary artery disease. Thromb Res 2007;120:245-250. https://doi.org/10.1016/j.thromres.2006.10.005
  29. Murat SN, Duran M, Kalay N, et al. Relation between mean platelet volume and severity of atherosclerosis in patients with acute coronary syndromes. Angiology 2013;64:131-136. https://doi.org/10.1177/0003319711436247
  30. Ekici B, Erkan AF, Alhan A, Sayin I, Ayli M, Tore HF. Is mean platelet volume associated with the angiographic severity of coronary artery disease? Kardiol Pol 2013;71:832-838. https://doi.org/10.5603/KP.2013.0195
  31. Kamath S, Blann AD, Lip GY. Platelet activation: assessment and quantification. Eur Heart J 2001;22:1561-1571. https://doi.org/10.1053/euhj.2000.2515
  32. Gawaz M, Langer H, May AE. Platelets in inflammation and atherogenesis. J Clin Invest 2005;115:3378-3384. https://doi.org/10.1172/JCI27196

피인용 문헌

  1. The Link Between Mean Platelet Volume to Lymphocyte Ratio and Complexity of Coronary Artery Disease vol.69, pp.4, 2016, https://doi.org/10.1177/0003319717743315
  2. Neutrophil Lymphocyte Ratio and Cardiovascular Disease Risk: A Systematic Review and Meta-Analysis vol.2018, pp.None, 2016, https://doi.org/10.1155/2018/2703518
  3. High red cell distribution width at the time of ST segment elevation myocardial infarction is better at predicting diastolic than systolic left ventricular dysfunction : A single-center prospective c vol.97, pp.18, 2016, https://doi.org/10.1097/md.0000000000010601
  4. Association between blood neutrophil-to-lymphocyte ratio and severity of coronary artery disease : Evidence from 17 observational studies involving 7017 cases vol.97, pp.39, 2016, https://doi.org/10.1097/md.0000000000012432
  5. Association between lifestyle and hematological parameters: A study of Chinese male steelworkers vol.33, pp.7, 2019, https://doi.org/10.1002/jcla.22946
  6. No correlation between mean platelet volume and carotid artery thickness in patients with diabetes at intermediate or high risk for cardiovascular diseases vol.32, pp.5, 2016, https://doi.org/10.1097/mbc.0000000000001037
  7. Nomograms Based on the Advanced Lung Cancer Inflammation Index for the Prediction of Coronary Artery Disease and Calcification vol.27, pp.None, 2016, https://doi.org/10.1177/10760296211060455