ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology
Predictors of poor coronary collateral development in patients with stable coronary artery disease: Neutrophil-to-lymphocyte ratio and platelets [Anatol J Cardiol]
Anatol J Cardiol. 2015; 15(3): 218-223 | DOI: 10.5152/akd.2014.5263

Predictors of poor coronary collateral development in patients with stable coronary artery disease: Neutrophil-to-lymphocyte ratio and platelets

Fatih Akın1, Burak Ayça2, Ömer Çelik3, Cem Şahin4
1Department of Cardiology, Faculty of Medicine, Muğla Sıtkı Koçman University; Muğla-Turkey
2Clinic of Cardiology, Bağcılar Education and Research Hospital; İstanbul-Turkey
3Department of Cardiology, Mehmet Akif Ersoy Chest and Cardiovascular Surgery Education and Research Hospital; İstanbul-Turkey
4Department of Internal Medicine, Faculty of Medicine, Muğla Sıtkı Koçman University; Muğla-Turkey

Objective: The heterogeneity in the degree of collateralization among patients with coronary artery disease (CAD) remains incompletely understood. We evaluated the predictors of poorly developed coronary collateral circulation (CCC) in patients with stable coronary artery disease.
 
Methods: Current  study is a retrospective study, consisting of 118  patients with poor CCC and 130 patients with good CCC. We investigated predictors of poor coronary collaterals in a cohort of 248 patients who had high-grade coronary stenosis or occlusion on their angiograms. To classify CCC, we used the Rentrop classification.
 
Results: Patients with poorly developed CCC had significantly higher neutrophil-to-lymphocyte ratio (N/L) compared with those with well-developed CCC, (4.2±2.8 vs. 3±3.1, p=0.001), whereas mean platelet volume, red cell distribution width and uric acid were not significantly different. Logistic regression analysis showed that N/L ratio (odds ratio 1.199, 95% confidence interval 1.045-1.375) and serum triglyceride levels [odds ratio (OR)=1.006, 95% confidence interval (CI)=1.001-1.010] were independent predictors of poorly developed CCC.
 
Conclusion: An elevated level of N/L ratio is independently associated with a significant impairment in coronary collateralization. Our findings suggest that N/L ratio is an inexpensive, universally available hematological marker for sufficiency of CCC in patients with stable coronary artery disease. 
 

Keywords: coronary collateral circulation; neutrophil to lymphocyte ratio, uric acid; hematologic parameters

Stabil koroner arter hastalarında zayıf koroner kollateral gelişiminin belirteçleri

Fatih Akın1, Burak Ayça2, Ömer Çelik3, Cem Şahin4
1Department of Cardiology, Faculty of Medicine, Muğla Sıtkı Koçman University; Muğla-Turkey
2Clinic of Cardiology, Bağcılar Education and Research Hospital; İstanbul-Turkey
3Department of Cardiology, Mehmet Akif Ersoy Chest and Cardiovascular Surgery Education and Research Hospital; İstanbul-Turkey
4Department of Internal Medicine, Faculty of Medicine, Muğla Sıtkı Koçman University; Muğla-Turkey

Amaç: Koroner arter hastalığı olan hastalarda koroner kollateral gelişiminin derecesindeki değişkenlik halen tam olarak anlaşılamamıştır. Biz stabil koroner arter hastalığı olan hastalarda zayıf koroner kollateral gelişiminin belirteçlerini değerlendirdik.
 
Yöntemler: Anjiyografisinde ciddi derecede darlığı veya tam tıkanıklığı olan 258 hastada zayıf koroner kollateral gelişiminin belirteçlerini araştırdık. Koroner kollateral gelişimini sınıflandırmak için, Rentrop sınıflandırmasını kullandık.
 
Bulgular: Zayıf koroner kollateral gelişimine sahip hastalar iyi gelişmiş koroner kollateral hastalarına oranla ciddi oranda daha yüksek nötrofil/lenfosit oranına sahipti, (4,2±2,8 karşı 3±3,1, p=0,001), ancak ortalama trombosit hacmi, eritrosit dağılım genişliği ürik asit farklı değildi. Lojistik regresyon analizi nötrofil lenfosit oranının zayıf koroner kollateral gelişiminin bağımsız bir belirteci olduğunu gösterdi (odds ratio 1,199, 95% confidence interval  1,045-1,375).
 
Sonuç: Artmış nötrofil/lenfosit oranı koroner kollateral gelişiminde ciddi bir bozulma ile ilişkilidir. Bizim bulgularımız stabil koroner arter hastalığı olan hastalarda nötrofil/lenfosit oranının koroner kollateral dolaşımın yeterliliğinin, ucuz, her yerde ulaşılabilen bir hematolojik marker olabileceğini akla getirmektedir.

Anahtar Kelimeler: koroner kollateral dolaşım, nötrofil/lenfosit oranı, ürik asit, hematolojik parametreler.

Fatih Akın, Burak Ayça, Ömer Çelik, Cem Şahin. Predictors of poor coronary collateral development in patients with stable coronary artery disease: Neutrophil-to-lymphocyte ratio and platelets. Anatol J Cardiol. 2015; 15(3): 218-223
Manuscript Language: English


Journal Metrics

Journal Citation Indicator: 0.18
CiteScore: 1.1
Source Normalized Impact
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SCImago Journal Rank: 0.348

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