Author + information
- Hakan Akıllı,
- Mehmet Kayrak,
- Hajrudin Alibasiç,
- Alpay Arıbaş,
- Oğuzhan Yıldırım,
- Mustafa Karanfil,
- Ahmet Lütfi Sertdemir,
- Ufuk Tan Bayram,
- Kurtuluş Özdemir and
- Hasan Gök
Neutrophil / lymphocytes (N / L) ratio is an indicator of systemic inflammation. It is shown that N/L ratio is a predictor of cardiac events and mortality at acute coronary syndrome and stable coronary artery disease. The relationship between presence and extent of myocardial ischemia with the N / L ratio is unknown. In this study, it was investigated whether there is a relationship between myocardial ischemia detected at dobutamine stress echocardiography (DSE) and N / L ratio.
A total of 917 patients who had known or suspected coronary artery disease, had ejection fraction ≥40 and were decided to perform DSE for investigating ischemia included to this prospective study between October 2009 and March 2013. Patients were divided into two groups based on their DSE results as positive DSE and negative DSE. Based on the number of ischemic segments detected at DSE, patients were divided into three groups: no ischemia at DSE (DSE negative group), ischemia at 1-3 segments, ischemia at 4 or more segments.
640 (69,8%) of 917 patients who were included in the study had no ischemia in DSE (DSE negative group, mean age 58,9±9,9 years,51,6% female). Ischemia was detected at 277 patients (DSE positive group, mean age 60,5±9,6 years, 38,6% female). Demographic and laboratory characteristics of the positive and negative DSE groups are presented in table 1. N/L ratio of DSE positive group was significantly higher than DSE negative group [N/L ratios: 2,6±1.6, 2,2±1.0 (103/mm3) respectively, p<0.001]. N/L ratios based on the number of ischemic segment are presented at table 2. N/L ratios of patient who had ischemia at 1-3 and 4 and more segments had significantly higher N/L ratios compared to DSE negative group.
A relationship was found between N/L and myocardial ischemia detected at DSE in our study. This finding suggests that underlying ischemia may be responsible from the relationship between N/L ratio and increased cardiovascular mortality.
|DSE negative (n=640)||DSE positive (n=277)||p|
|Female gender n (%)||330 (51.6)||107 (38.6)||<0.001|
|Hypertension n (%)||155 (24.2)||102 (36.8)||0.01|
|Diabetes mellitus n (%)||176 (27.5)||87 (31.4)||0.26|
|Smoking n (%)||158 (24.7)||78 (28.1)||0.19|
|Known coronary artery disease n (%)||148 (23.1)||115 (41.5)||<0.01|
|Creatinine clearance (ml/min)||94.4±23.1||94.6±22.1||0.92|
|White blood cell count (103/mm3)||7.2±1.6||7.6±1.7||<0.001|
DSE: Dobutamine stress echocardiography
|DSE negative (n=640)||1-3 segment ischemia (n=180)||4 and above segment ischemia (n=97)||p|
* Comparison of DSE negative group according to Post hoc Tukey test p<0.05 DSE: Dobutamine stress echocardiography