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Yuan S, Li L, Pu T, Fan X, Wang Z, Xie P, Li P. The relationship between NLR, LDL-C/HDL-C, NHR and coronary artery disease. PLoS One 2024; 19:e0290805. [PMID: 38985788 DOI: 10.1371/journal.pone.0290805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 05/23/2024] [Indexed: 07/12/2024] Open
Abstract
OBJECTIVE Chronic inflammation and dyslipidemia are key risk factors for atherosclerotic cardiovascular diseases. We retrospectively explored the association between the neutrophil to lymphocyte ratio (NLR), the ratio of low-density lipoprotein cholesterol (LDL-C) to high-density lipoprotein cholesterol (HDL-C), and the neutrophil to HDL-C ratio (NHR), and the severity of coronary lesions in patients with acute coronary syndrome (ACS). METHOD In June 2023, we selected 1210 patients who were diagnosed with ACS based on chest pain from January 2017 to December 2022. Of these, 1100 patients with abnormal coronary angiography were categorized into the experimental group, and 110 patients with normal coronary angiography were classified as the control group. We collected routine blood tests, lipid profiles, and coronary angiography results at admission (before coronary angiography). Patients were then stratified into a control group (Gensini score = 0) and an experimental group (Gensini score = 0) based on the Gensini score. The experimental group was further divided into a low score group (Gensini score < 69) and a high score group (Gensini score ≥ 69). RESULT 1. Statistically significant differences were observed between the control and experimental groups in terms of gender, age, body mass index (BMI), hypertension, diabetes, smoking history, and counts of neutrophils (NEU), lymphocytes (LYM), monocytes (MON), eosinophils (EOS), red cell distribution width (RDW), total cholesterol (TC), HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR (P<0.05). Furthermore, differences in BMI, hypertension, diabetes, smoking history, NEU, LYM, MON, TC, triglyceride (TG), HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR were significant between the low and high score groups (P<0.05). 2. NEU, LYM, MON, TC, HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR showed significant correlations with the Gensini score (r>0.2, P<0.05), with NLR and LDL-C/HDL-C showing the strongest correlations (r = 0.822, P = 0.000). 3. The Receiver Operating Characteristic (ROC) curve indicated that the combination of NLR and LDL-C/HDL-C had superior sensitivity and specificity in predicting the severity of coronary lesions, with a significant difference (P<0.05). The sensitivity was 87.1%, the specificity was 90.9%, and the cut-off point was 2.04. 4. A predictive model was developed based on the ratio of NLR and LDL-C/HDL-C to the Gensini score. The final model score was calculated as 6.803 + 7.029NLR + 13.079LDL-C/HDL-C (R2 = 0.708). CONCLUSION Compared to NLR, LDL-C/HDL-C, and NHR, the combined NLR and LDL-C/HDL-C ratio is a more accurate marker for assessing the severity of coronary artery disease in ACS patients. Its convenience and effectiveness make it a promising tool for early assessment, timely risk stratification, and appropriate clinical intervention, ultimately improving clinical outcomes for ACS patients.
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Affiliation(s)
- Shuaishuai Yuan
- Division of Cardiovascular Intensive Care (C-ICU), Cardiac and Vascular Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Lingling Li
- China Medical University, Shenyang, Liaoning, China
| | - Tian Pu
- The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xizhen Fan
- Division of Life Science and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, China
| | - Zheng Wang
- The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Pailing Xie
- Division of Cardiovascular Intensive Care (C-ICU), Cardiac and Vascular Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Peijun Li
- Division of Cardiovascular Intensive Care (C-ICU), Cardiac and Vascular Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen, Guangdong, China
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Jercălău CE, Andrei CL, Brezeanu LN, Darabont RO, Guberna S, Catană A, Lungu MD, Ceban O, Sinescu CJ. Lymphocyte-to-Red Blood Cell Ratio-The Guide Star of Acute Coronary Syndrome Prognosis. Healthcare (Basel) 2024; 12:1205. [PMID: 38921319 PMCID: PMC11203887 DOI: 10.3390/healthcare12121205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/09/2024] [Accepted: 06/12/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Beneath the surface of the acute ST-elevation myocardial infarction (STEMI) iceberg lies a hidden peril, obscured by the well-known cardiovascular risk factors that tip the iceberg. Before delving into the potential time bomb these risk factors represent, it is crucial to recognize the obscured danger lurking under the surface. What secrets does the STEMI iceberg hold? To unveil these mysteries, a closer look at the pathophysiology of STEMI is imperative. Inflammation, the catalyst of the STEMI cascade, sets off a chain reaction within the cardiovascular system. Surprisingly, the intricate interplay between red blood cells (RBC) and lymphocytes remains largely unexplored in previous research. MATERIALS AND METHODS The study encompassed 163 patients diagnosed with STEMI. Utilizing linear and logistic regression, the lymphocyte-to-red blood cell ratio (LRR) was scrutinized as a potential predictive biomarker. RESULTS There was a statistically significant correlation between LRR and the prognosis of STEMI patients. Building upon this discovery, an innovative scoring system was proposed that integrates LRR as a crucial parameter. CONCLUSIONS Uncovering novel predictive markers for both immediate and delayed complications in STEMI is paramount. These markers have the potential to revolutionize treatment strategies by tailoring them to individual risk profiles, ultimately enhancing patient outcomes.
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Affiliation(s)
- Cosmina Elena Jercălău
- Department of Cardiology, “Bagdasar Arseni” Emergency Hospital, University of Medicine and Pharmacy “Carol Davila”, 011241 Bucharest, Romania; (R.O.D.); (A.C.); (C.J.S.)
| | - Cătălina Liliana Andrei
- Department of Cardiology, “Bagdasar Arseni” Emergency Hospital, University of Medicine and Pharmacy “Carol Davila”, 011241 Bucharest, Romania; (R.O.D.); (A.C.); (C.J.S.)
| | - Lavinia Nicoleta Brezeanu
- Department of Anaesthesia and Intensive Care, Fundeni Clinical Institute, 022328 Bucharest, Romania;
| | - Roxana Oana Darabont
- Department of Cardiology, “Bagdasar Arseni” Emergency Hospital, University of Medicine and Pharmacy “Carol Davila”, 011241 Bucharest, Romania; (R.O.D.); (A.C.); (C.J.S.)
| | - Suzana Guberna
- Department of Cardiology, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.G.); (M.D.L.)
| | - Andreea Catană
- Department of Cardiology, “Bagdasar Arseni” Emergency Hospital, University of Medicine and Pharmacy “Carol Davila”, 011241 Bucharest, Romania; (R.O.D.); (A.C.); (C.J.S.)
| | - Maria Diana Lungu
- Department of Cardiology, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.G.); (M.D.L.)
| | - Octavian Ceban
- Economic Cybernetics and Informatics Department, The Bucharest University of Economic Studies, 010374 Bucharest, Romania;
| | - Crina Julieta Sinescu
- Department of Cardiology, “Bagdasar Arseni” Emergency Hospital, University of Medicine and Pharmacy “Carol Davila”, 011241 Bucharest, Romania; (R.O.D.); (A.C.); (C.J.S.)
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Merdler I, Chitturi KR, Chaturvedi A, Li J, Cellamare M, Ozturk ST, Sawant V, Ben-Dor I, Waksman R, Case BC, Hashim HD. Coronary microvascular dysfunction and inflammation: Insights from the Coronary Microvascular Disease Registry. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2024:S1553-8389(24)00488-3. [PMID: 38789342 DOI: 10.1016/j.carrev.2024.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Coronary microvascular dysfunction (CMD) is associated with various inflammatory conditions that worsen endothelial dysfunction. This study aimed to investigate the relationship between CMD and inflammation using common inflammatory markers derived from complete blood count (CBC) analysis. METHODS Information was gathered from the Coronary Microvascular Disease Registry to examine the neutrophil-to-lymphocyte ratio (NLR), eosinophil-to-monocyte ratio (EMR), and monocyte-to-high-density lipoprotein ratio (MHR) in a cohort of patients with angina who showed non-obstructive coronary arteries and underwent invasive physiological assessments for CMD. RESULTS Of the 171 patients studied, 126 were CMD-negative and 45 were CMD-positive, constituting two groups of interest. The average age of all patients was 61.7 ± 11.1 years, and 63.7 % were female. No significant differences were observed between the two groups in terms of baseline characteristics, cardiovascular risk factors, or potential anti-inflammatory medications. Furthermore, there were no statistically significant differences in NLR (2.54 ± 3.71 vs. 2.52 ± 2.28, p = 0.97), EMR (0.3 ± 0.21 vs. 0.34 ± 0.29, p = 0.31), or MHR (0.02 ± 0.01 vs. 0.01 ± 0.01, p = 0.54) between CMD-positive and CMD-negative patients. CONCLUSION Our findings did not show a noteworthy connection between CMD and inflammation, as suggested by various simple CBC-based biomarkers.
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Affiliation(s)
- Ilan Merdler
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Kalyan R Chitturi
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Abhishek Chaturvedi
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Jason Li
- Department of Internal Medicine, MedStar Georgetown University Hospital, Washington, DC, United States of America
| | - Matteo Cellamare
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Sevket Tolga Ozturk
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Vaishnavi Sawant
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Itsik Ben-Dor
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Ron Waksman
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America.
| | - Brian C Case
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Hayder D Hashim
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
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Jercălău CE, Andrei CL, Darabont RO, Guberna S, Staicu AM, Rusu CT, Ceban O, Sinescu CJ. Blood Cell Ratios Unveiled: Predictive Markers of Myocardial Infarction Prognosis. Healthcare (Basel) 2024; 12:824. [PMID: 38667586 PMCID: PMC11049867 DOI: 10.3390/healthcare12080824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/03/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Even if the management and treatment of patients with non-ST-elevation myocardial infarction (NSTEMI) have significantly evolved, it is still a burgeoning disease, an active volcano with very high rates of morbidity and mortality. Therefore, novel management and therapeutic strategies for this condition are urgently needed. Lately, theories related to the role of various blood cells in NSTEMI have emerged, with most of this research having so far been focused on correlating the ratios between various leukocyte types (neutrophil/lymphocyte ratio-NLR, neutrophil/monocyte ratio-NMR). But what about erythrocytes? Is there an interaction between these cells and leukocytes, and furthermore, can this relationship influence NSTEMI prognosis? Are they partners in crime? METHODS Through the present study, we sought, over a period of sixteen months, to evaluate the neutrophil/red blood cell ratio (NRR), monocyte/red blood cell ratio (MRR) and lymphocyte/red blood cell ratio (LRR), assessing their potential role as novel prognostic markers in patients with NSTEMI. RESULTS There was a statistically significant correlation between the NRR, LRR, MRR and the prognosis of NSTEMI patients. CONCLUSIONS These new predictive markers could represent the start of future innovative therapies that may influence crosstalk pathways and have greater benefits in terms of cardiac repair and the secondary prevention of NSTEMI.
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Affiliation(s)
- Cosmina Elena Jercălău
- Department of Cardiology, “Bagdasar Arseni” Emergency Hospital, University of Medicine and Pharmacy “Carol Davila”, 011241 Bucharest, Romania; (R.O.D.); (C.J.S.)
| | - Cătălina Liliana Andrei
- Department of Cardiology, “Bagdasar Arseni” Emergency Hospital, University of Medicine and Pharmacy “Carol Davila”, 011241 Bucharest, Romania; (R.O.D.); (C.J.S.)
| | - Roxana Oana Darabont
- Department of Cardiology, “Bagdasar Arseni” Emergency Hospital, University of Medicine and Pharmacy “Carol Davila”, 011241 Bucharest, Romania; (R.O.D.); (C.J.S.)
| | - Suzana Guberna
- Department of Cardiology, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.G.); (A.M.S.)
| | - Arina Maria Staicu
- Department of Cardiology, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.G.); (A.M.S.)
| | - Cătălin Teodor Rusu
- Department of Internal Medicine, “Coltea” Clinical Hospital, 030167 Bucharest, Romania;
| | - Octavian Ceban
- Economic Cybernetics and Informatics Department, The Bucharest University of Economic Studies, 010374 Bucharest, Romania;
| | - Crina Julieta Sinescu
- Department of Cardiology, “Bagdasar Arseni” Emergency Hospital, University of Medicine and Pharmacy “Carol Davila”, 011241 Bucharest, Romania; (R.O.D.); (C.J.S.)
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Zhao X, Yang Y, Pan Z, Lv W, Rao X, Wang X, Yu X. Plateletcrit is predictive of clinical outcome and prognosis for early-stage breast cancer: A retrospective cohort study based on propensity score matching. Cancer Med 2024; 13:e6944. [PMID: 38348939 PMCID: PMC10832319 DOI: 10.1002/cam4.6944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 12/12/2023] [Accepted: 01/06/2024] [Indexed: 02/15/2024] Open
Abstract
PURPOSE Breast cancer (BC) is diagnosed as the most common cancer in women in 2022 according to the American Cancer Society. It is essential to detect early and treat early. Several studies have shown that some blood parameters have important predictive value for BC. In this study, we aim to explore whether some immune-associated blood parameters are relevant to disease-free survival (DFS) in early-stage BC. METHODS A single-center, regression cohort study of 1490 patients with early-stage BC in Shanghai Cancer Center was conducted from January 2008 to December 2016. The patients were matched according to the ratio of 1:1 based on Propensity Score Matching (PSM). All patients who experienced disease progression were matched successfully. Thus, 58 pairs of subjects were obtained. Matched blood parameters were evaluated by paired samples t-test or Wilcoxon signed-rank test. Factors with statistical difference were further evaluated by stratified COX regression model. RESULTS Univariate analysis showed differences in platelet-related parameters (PLT, PCT, and PLR) and NLR between the two matched groups. However, stratified COX regression analysis, which ruled out the confounding effects of multiple factors, found that only PCT had prognostic value in early BC patients at baseline and study endpoint. Meanwhile, platelet-related parameters (PLT, MPV) and NLR were different in the progressive group by self before and after comparison. However, the multiple-factor analysis showed that only the NLR had prognostic value. ROC curve analysis indicated that the best sensitivity (65.45%) and specificity (78.18%) were obtained when the baseline PCT was 0.225. The optimal sensitivity (70.91%) and specificity (65.45%) were obtained when the PCT of disease progression was 0.215. The Kaplan-Meier curve was used to calculate the DFS rate based on the critical values of the two groups. CONCLUSIONS Some blood parameters have value to predict DFS in early-stage BC patients, especially platelet-associated parameters.
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Affiliation(s)
- Xu Zhao
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
- Shanghai Clinical Research Center for Radiation OncologyShanghaiChina
- Shanghai Key Laboratory of Radiation OncologyShanghaiChina
| | - Yilan Yang
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
- Shanghai Clinical Research Center for Radiation OncologyShanghaiChina
- Shanghai Key Laboratory of Radiation OncologyShanghaiChina
| | - Zhe Pan
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
- Shanghai Clinical Research Center for Radiation OncologyShanghaiChina
- Shanghai Key Laboratory of Radiation OncologyShanghaiChina
| | - Weiluo Lv
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
- Shanghai Clinical Research Center for Radiation OncologyShanghaiChina
- Shanghai Key Laboratory of Radiation OncologyShanghaiChina
| | - Xinxin Rao
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
- Shanghai Clinical Research Center for Radiation OncologyShanghaiChina
- Shanghai Key Laboratory of Radiation OncologyShanghaiChina
| | - Xuanyi Wang
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
- Shanghai Clinical Research Center for Radiation OncologyShanghaiChina
- Shanghai Key Laboratory of Radiation OncologyShanghaiChina
| | - Xiaoli Yu
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
- Shanghai Clinical Research Center for Radiation OncologyShanghaiChina
- Shanghai Key Laboratory of Radiation OncologyShanghaiChina
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Pruc M, Peacock FW, Rafique Z, Swieczkowski D, Kurek K, Tomaszewska M, Katipoglu B, Koselak M, Cander B, Szarpak L. The Prognostic Role of Platelet-to-Lymphocyte Ratio in Acute Coronary Syndromes: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:6903. [PMID: 37959368 PMCID: PMC10650024 DOI: 10.3390/jcm12216903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
This study aimed to investigate the potential prognostic role of the platelet-to-lymphocyte (PLR) ratio in patients presenting with suspected acute coronary syndromes (ACS). A systematic search of PubMed Central, Scopus, EMBASE, and the Cochrane Library from conception through 20 August 2023 was conducted. We used odds ratios (OR) as the effect measure with 95% confidence intervals (CIs) for dichotomous data and mean differences (MD) with a 95% CI for continuous data. If I2 was less than 50% or the p value of the Q tests was less than 0.05, a random synthesis analysis was conducted. Otherwise, a fixed pooled meta-analysis was performed. Nineteen studies fulfilled the eligibility criteria and were included in the meta-analysis. PLR was higher in MACE-positive (164.0 ± 68.6) than MACE-negative patients (115.3 ± 36.9; MD = 40.14; 95% CI: 22.76 to 57.52; p < 0.001). Pooled analysis showed that PLR was higher in AMI patients who died (183.3 ± 30.3), compared to survivors (126.2 ± 16.8; MD = 39.07; 95% CI: 13.30 to 64.84; p = 0.003). It was also higher in the ACS vs. control group (168.2 ± 81.1 vs. 131.9 ± 37.7; MD = 39.01; 95% CI: 2.81 to 75.21; p = 0.03), STEMI vs. NSTEMI cohort (165.5 ± 92.7 vs. 159.5 ± 87.8; MD = 5.98; 95% CI: -15.09 to 27.04; p = 0.58), and MI vs. UAP populations (162.4 ± 90.0 vs. 128.2 ± 64.9; MD = 18.28; 95% CI: -8.16 to 44.71; p = 0.18). Overall, our findings confirmed the potential prognostic role of the plate-let-to-lymphocyte (PLR) ratio in patients presenting with suspected acute coronary syndromes (ACS). Its use as a risk stratification tool should be examined prospectively to define its capability for evaluation in cardiovascular patients.
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Affiliation(s)
- Michal Pruc
- Department of Public Health, International European University, 03187 Kyiv, Ukraine
| | - Frank William Peacock
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Zubaid Rafique
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Damian Swieczkowski
- Department of Toxicology, Faculty of Pharmacy, Medical University of Gdansk, 80-416 Gdansk, Poland
| | - Krzysztof Kurek
- Department of Clinical Research and Development, LUXMED Group, 02-676 Warsaw, Poland
| | - Monika Tomaszewska
- Department of Clinical Research and Development, LUXMED Group, 02-676 Warsaw, Poland
| | - Burak Katipoglu
- Department of Emergency Medicine, Ufuk University Medical Faculty, 06510 Ankara, Turkey
| | - Maciej Koselak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, 00-136 Warsaw, Poland
| | - Basar Cander
- Department of Emergency Medicine, Bezmialem Vakif University, Fatih, 34093 Istanbul, Turkey
| | - Lukasz Szarpak
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Clinical Research and Development, LUXMED Group, 02-676 Warsaw, Poland
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Vakhshoori M, Nemati S, Sabouhi S, Shakarami M, Yavari B, Emami SA, Bondariyan N, Shafie D. Prognostic impact of monocyte-to-lymphocyte ratio in coronary heart disease: a systematic review and meta-analysis. J Int Med Res 2023; 51:3000605231204469. [PMID: 37848392 PMCID: PMC10586014 DOI: 10.1177/03000605231204469] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/13/2023] [Indexed: 10/19/2023] Open
Abstract
OBJECTIVE Inflammatory biomarkers are novel tools to assess the prognosis of different cardiovascular diseases. We evaluated the impact of the monocyte-to-lymphocyte ratio (MLR) on clinical outcomes in patients with coronary heart disease (CHD). METHODS We systematically screened English-language articles in PubMed, Scopus, and Web of Science to 31 August 2022. Relevant articles reporting the MLR and its association with clinical outcomes (major adverse cardiovascular events (MACE), coronary artery disease (CAD) severity, mortality, cardiac rupture, subclinical CAD, acute coronary syndrome (ACS) prediction, thin-cap fibroatheroma, no-reflow phenomenon, MLR-related differences in percutaneous coronary intervention, heart failure hospitalization, and depression) in patients with CHD were collected for further analysis. RESULTS Nineteen articles were selected. The mean MLR was 0.34. A higher MLR was significantly associated with an increased risk of MACE among patients with CHD. The MLR was an independent predictor of MACE in patients with ACS. No significant association was found for CAD severity. A complementary analysis was not performed because of few studies focusing on the other predefined endpoints. CONCLUSIONS The MLR is a simple and widely available tool to predict MACE in patients with CHD. This biomarker can be utilized in emergency settings to prioritize high-risk patients and optimize therapeutic interventions.
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Affiliation(s)
- Mehrbod Vakhshoori
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sepehr Nemati
- School of Medicine, Tehran Azad University of Medical Sciences, Tehran, Iran
| | - Sadeq Sabouhi
- Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrnaz Shakarami
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behzad Yavari
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sayed Ali Emami
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Niloofar Bondariyan
- Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Davood Shafie
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Donato G, Pennisi MG, Persichetti MF, Archer J, Masucci M. A Retrospective Comparative Evaluation of Selected Blood Cell Ratios, Acute Phase Proteins, and Leukocyte Changes Suggestive of Inflammation in Cats. Animals (Basel) 2023; 13:2579. [PMID: 37627371 PMCID: PMC10451877 DOI: 10.3390/ani13162579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), and platelet-to-lymphocyte (PLR) ratios have been proposed as diagnostic and prognostic markers for neoplastic and inflammatory diseases in dogs and cats. The aim of this retrospective preliminary study was to evaluate the relationship between these ratios and markers of inflammation routinely measured in cats. A total of 275 cats were enrolled. Complete blood count, serum amyloid A (SAA), albumin, globulin, and albumin-to-globulin ratio (AGR) data were analyzed, as well as the presence of leukocyte alterations considered suggestive of inflammation (LAI: neutrophils left shift, toxic neutrophils, and reactive lymphocytes) evaluated in blood smears. The NLR and MLR correlated positively with SAA and globulins and negatively with albumin and AGR. Higher NLR and MLR were found in cats with increased SAA and globulins and decreased albumin and AGR. The PLR correlated negatively with albumin and AGR. A higher PLR was found in cats with hypoalbuminemia. Cats with LAI had higher NLR, MLR, and PLR. In cats with no changes in parameters indicative of inflammation, 11.25, 0.42, and 528.3 were identified as upper limits for NLR, MLR, and PLR, respectively. In conclusion, the NLR, MLR, and PLR act as good inflammatory markers easily evaluated by routine hematology.
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Affiliation(s)
- Giulia Donato
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy; (M.G.P.); (M.F.P.)
| | - Maria Grazia Pennisi
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy; (M.G.P.); (M.F.P.)
| | | | - Joy Archer
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK;
| | - Marisa Masucci
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy; (M.G.P.); (M.F.P.)
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Towards a biomarker for acute arterial thrombosis using complete blood count and white blood cell differential parameters in mice. Sci Rep 2023; 13:4043. [PMID: 36899036 PMCID: PMC10006076 DOI: 10.1038/s41598-023-31122-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
There is no blood biomarker diagnostic of arterial thrombosis. We investigated if arterial thrombosis per se was associated with alterations in complete blood count (CBC) and white blood cell (WBC) differential count in mice. Twelve-week-old C57Bl/6 mice were used for FeCl3-mediated carotid thrombosis (n = 72), sham-operation (n = 79), or non-operation (n = 26). Monocyte count (/µL) at 30-min after thrombosis (median 160 [interquartile range 140-280]) was ~ 1.3-fold higher than at 30-min after sham-operation (120 [77.5-170]), and twofold higher than in non-operated mice (80 [47.5-92.5]). At day-1 and -4 post-thrombosis, compared with 30-min, monocyte count decreased by about 6% and 28% to 150 [100-200] and 115 [100-127.5], which however were about 2.1-fold and 1.9-fold higher than in sham-operated mice (70 [50-100] and 60 [30-75], respectively). Lymphocyte counts (/µL) at 1- and 4-days after thrombosis (mean ± SD; 3513 ± 912 and 2590 ± 860) were ~ 38% and ~ 54% lower than those in the sham-operated mice (5630 ± 1602 and 5596 ± 1437, respectively), and ~ 39% and ~ 55% lower than those in non-operated mice (5791 ± 1344). Post-thrombosis monocyte-lymphocyte-ratio (MLR) was substantially higher at all three time-points (0.050 ± 0.02, 0.046 ± 0.025, and 0.050 ± 0.02) vs. sham (0.003 ± 0.021, 0.013 ± 0.004, and 0.010 ± 0.004). MLR was 0.013 ± 0.005 in non-operated mice. This is the first report on acute arterial thrombosis-related alterations in CBC and WBC differential parameters.
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Zhang X, Zhang T, Wu C, Zhou Y, Chen Z, Xu R. The association between inflammatory biomarkers and carotid artery plaque in normal-weight and metabolically healthy Chinese adults: a cross-sectional study. Hypertens Res 2023; 46:330-338. [PMID: 36224287 DOI: 10.1038/s41440-022-01062-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 09/02/2022] [Accepted: 09/10/2022] [Indexed: 02/07/2023]
Abstract
Existing evidence has indicated a role of inflammation in the development of carotid artery plaque (CAP). We thus evaluated the association between inflammation and CAP in a population with normal body weight and metabolically healthy status. A total of 8050 normal-body-weight and metabolically healthy participants (2613 men and 5437 women, aged 40.5 ± 11.3 y) were included in this study. Inflammatory status was evaluated by three parameters: serum hs-CRP (high-sensitivity C-reactive protein), WBC (white blood cell) count, and NLR (neutrophil-to-lymphocyte ratio). CAP was detected by ultrasound B-mode imaging. Clinical data were abstracted from medical records. Metabolically healthy status was defined as no history of metabolic diseases and normal blood pressure, fasting blood glucose level, hemoglobin A1c level, lipid profile, and liver ultrasonographic findings. The serum level of hs-CRP, but not WBC or NLR, was associated with the risk of CAP after adjustment for age, sex, BMI, blood pressure, fasting blood glucose, glycated hemoglobin A1c, lipid profile, and estimated glomerular filtration rate. The adjusted odds ratio for the risk of CAP was 2.71 (1.64, 4.46) for participants with a high level of hs-CRP (≥3 mg/L), compared with those with a low level (<1 mg/L). Each unit increase in hs-CRP was associated with a 24% higher risk of CAP (OR = 1.24; 95% CI: 1.12, 1.37). Inflammation was associated with the risk of CAP even in individuals with a normal body weight and metabolically healthy status.
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Affiliation(s)
- Xiaomin Zhang
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ting Zhang
- Department of Vascular Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chunhua Wu
- Department of Ultrasound, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yiquan Zhou
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhiqi Chen
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Renying Xu
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Rosca O, Bumbu BA, Ancusa O, Talpos S, Urechescu H, Ursoniu S, Bloanca V, Pricop M. The Role of C-Reactive Protein and Neutrophil to Lymphocyte Ratio in Predicting the Severity of Odontogenic Infections in Adult Patients. MEDICINA (KAUNAS, LITHUANIA) 2022; 59:medicina59010020. [PMID: 36676644 PMCID: PMC9866968 DOI: 10.3390/medicina59010020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/11/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
Background and Objectives: Odontogenic infections (OI) represent a frequent cause of dental and maxillo-facial interventions, mostly due to late presentations or misdiagnosed complications. It is believed that the intensity of the immunoinflammatory response in OI is the main prognostic factor. Therefore, in this research, it was pursued to determine if the combination of C-reactive protein (CRP) and Neutrophil to Lymphocyte Ratio (NLR) (CRP-NLR) may serve as potential severity predictors in patients with odontogenic infections. Materials and Methods: A retrospective analysis on 108 patients hospitalized for odontogenic infections was conducted at the Department of Maxillofacial Surgery. Depending on the symptom severity scale, patients hospitalized with OI were divided into two equal groups based on infection severity (SS). Results: Patients with severe OI from Group B were associated more frequently with diabetes mellitus and smoking more often than those with a lower severity from Group A. In Group A, abscesses of odontogenic origin accounted for 70.4% of hospitalizations, while in Group B, abscesses and cellulitis were associated in 55.6% of cases (p-value < 0.001). The disease outcomes were more severe in Group B patients, where 22.2% of them developed sepsis, compared to 7.4% of Group A patients (p-value = 0.030). However, there was no significant difference in mortality rates. The SS and systemic immune inflammation index (SII) scores of Group B patients were substantially higher than Group A patients (13.6 vs. 6.1 for the SS score, p-value < 0.001), respectively, 2312.4 vs. 696.3 for the SII score (p-value < 0.001). All biomarker scores, including the CRP-NLR relationship, were considerably higher in Group B patients, with a median score of 341.4 vs. 79.0 in Group B (p-value < 0.001). The CRP-NLR association determined a 7.28-fold increased risk of severe OI. The receiver operating curve (ROC) analysis of CRP-NLR yielded an area under curve (AUC) value of 0.889, with high sensitivity (79.6%) and high specificity (85.1%), for predicting a severe odontogenic infection using biomarkers measured at hospital admission (p-value < 0.001). Conclusions: Therefore, it can be concluded that CRP-NLR is a reliable and affordable biomarker for determining the severity of odontogenic infections that may be included in other prognostic models for dental infections.
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Affiliation(s)
- Ovidiu Rosca
- Department XIII, Discipline of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Bogdan Andrei Bumbu
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, University Street 1, 410087 Oradea, Romania
- Correspondence:
| | - Oana Ancusa
- Department V, Discipline of Medical Semiology I, Faculty of General Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Serban Talpos
- Discipline of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Horatiu Urechescu
- Discipline of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Sorin Ursoniu
- Department of Functional Sciences, Center for Translational Research and Systems Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Vlad Bloanca
- Department of Plastic Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Marius Pricop
- Discipline of Oral and Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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Chen X, Xiong S, Chen Y, Cheng L, Chen Q, Yang S, Qi L, Liu H, Cai L. The Predictive Value of Different Nutritional Indices Combined with the GRACE Score in Predicting the Risk of Long-Term Death in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention. J Cardiovasc Dev Dis 2022; 9:jcdd9100358. [PMID: 36286310 PMCID: PMC9604676 DOI: 10.3390/jcdd9100358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/16/2022] Open
Abstract
Nutritional status is associated with prognosis in acute coronary syndrome (ACS) patients. Although the Global Registry of Acute Coronary Events (GRACE) risk score is regarded as a relevant risk predictor for the prognosis of ACS patients, nutritional variables are not included in the GRACE score. This study aimed to compare the prognostic ability of the Geriatric Nutritional Risk Index (GNRI) and Prognostic Nutritional Index (PNI) in predicting long-term all-cause death in ACS patients undergoing percutaneous coronary intervention (PCI) and to determine whether the GNRI or PNI could improve the predictive value of the GRACE score. A total of 799 patients with ACS who underwent PCI from May 2018 to December 2019 were included and regularly followed up. The performance of the PNI in predicting all-cause death was better than that of the GNRI [C-index, 0.677 vs. 0.638, p = 0.038]. The addition of the PNI significantly improved the predictive value of the GRACE score for all-cause death [increase in C-index from 0.722 to 0.740; IDI 0.006; NRI 0.095; p < 0.05]. The PNI was superior to the GNRI in predicting long-term all-cause death in ACS patients undergoing PCI. The addition of the PNI to the GRACE score could significantly improve the prediction of long-term all-cause death.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Lin Cai
- Correspondence: (H.L.); (L.C.)
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Wang CJ, Pang CY, Huan-Yu, Cheng YF, Wang H, Deng BB, Huang HJ. Monocyte-to-lymphocyte ratio affects prognosis in LAA-type stroke patients. Heliyon 2022; 8:e10948. [PMID: 36247122 PMCID: PMC9561738 DOI: 10.1016/j.heliyon.2022.e10948] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/04/2022] [Accepted: 09/29/2022] [Indexed: 11/02/2022] Open
Abstract
Nowadays, the prognostic prediction of acute ischemic stroke (AIS) patients is still challenging because of the limited predictive properties of existing models. Blood-based biomarkers may provide additional information to the established prognostic factors. Markers of atherosclerosis have been identified as one of the most promising biomarkers for predicting prognosis, and inflammation, in turn, affects atherosclerosis. According to previous studies, the ratio of monocytes to lymphocytes (MLR) has been reported as a novel indicator of inflammation. Thus, our study was the first to conduct more in-depth research on the relationship between MLR and the prognosis of large artery atherosclerosis (LAA)-type AIS patients. A total of 296 patients with LAA-type stroke were recruited. Of these, 202 patients were assigned to the development cohort, and 94 patients were assigned to the validation cohort. In the development cohort, 202 patients were divided into groups A, B, C, and D according to the quartile method of MLR levels. The one-year prognosis of patients was tracked, and the modified Rankin scale (MRS, with a score ranging from 0 to 6) was mainly selected as the measurement result of the function. The relationship between MLR and prognosis was analyzed by building logistics regression models. The models showed that MLR made significant predictions in poor outcomes of LAA-type stroke patients (odds ratio: 4.037; p = 0.048). At the same time, receiver operating characteristics (ROC) curves were used to compare the predictive values between MLR and clinical prediction score (Barthel Index). This study demonstrated that patients with LAA-type stroke and high MLR had a poor prognosis. MLR might be a reliable, inexpensive, and novel predictor of LAA-type stroke prognosis.
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Mitić B, Jovanović A, Nikolić VN, Stokanović D, Andrejić OM, Vučić RM, Pavlović M, Ignjatović A, Momčilović S. Trend of Galectin-3 Levels in Patients with Non-ST-Elevation and ST-Elevation Myocardial Infarction. Medicina (B Aires) 2022; 58:medicina58020286. [PMID: 35208606 PMCID: PMC8874376 DOI: 10.3390/medicina58020286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 02/02/2022] [Accepted: 02/07/2022] [Indexed: 11/27/2022] Open
Abstract
Background and Objectives: Given the fact that galectin-3 has a predictive significance on the development of myocardial dysfunction after acute myocardial infarction, the aim of our study was to examine potential factors that could be important for the dynamics of the concentration of this biomarker in the early postinfarction period. Materials and Methods: This study included 89 patients with a diagnosis of stable angina pectoris (SAP) or the first non-ST elevation (NSTEMI) or ST-elevation (STEMI) myocardial infarction, who underwent percutaneous coronary intervention (PCI). The study group included 23 patients with the first NSTEMI and 42 patients with STEMI, while the control group consisted of 24 patients with SAP hospitalized for elective PCI without a previous MI. All patients had preserved left ventricular ejection fraction. Galectin-3 levels were determined on days 1, 5, and 30 after PCI. The significance of various independent variables as predictors of galectin-3 concentration was analyzed after a series of univariate linear regression modeling in a multivariate linear regression model. Results: The average patients’ age was 63.99 ± 9.13 years. Statistically significantly higher values of C-reactive protein were established in STEMI compared to SAP (p < 0.01) or NSTEMI (p < 0.001), whereas WBC count was significantly lower in SAP than in STEMI (p < 0.001) and NSTEMI (p < 0.01) group. Although there were no statistically significant differences in measured galectin-3 concentrations between the examined groups on days 1, 5, and 30 after PCI, HTA, triglyceride level, LA size, treatment with trimetazidine and long-acting nitrates, as well as percentage of LM stenosis and E/A ratio were identified as independent predictors of galectin-3 concentration. Conclusions: In the post-MI period, very early values of galectin-3 correlate mostly with atherosclerosis factors, while on day 30 this biomarker correlates with diastolic dysfunction and “announces” left ventricular remodeling.
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Affiliation(s)
- Branka Mitić
- Department of Internal Medicine-Nephrology, Faculty of Medicine, University of Nis, Blvd Zorana Djindjića 81, 18000 Nis, Serbia; (B.M.); (A.J.)
| | - Andriana Jovanović
- Department of Internal Medicine-Nephrology, Faculty of Medicine, University of Nis, Blvd Zorana Djindjića 81, 18000 Nis, Serbia; (B.M.); (A.J.)
| | - Valentina N. Nikolić
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Nis, Blvd Zorana Djindjića 81, 18000 Nis, Serbia; (V.N.N.); (D.S.)
| | - Dragana Stokanović
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Nis, Blvd Zorana Djindjića 81, 18000 Nis, Serbia; (V.N.N.); (D.S.)
| | - Olivera M. Andrejić
- Clinic for Pulmonary Diseases, University Clinical Center Kragujevac, Zmaj Jovina Street 30, 34000 Kragujevac, Serbia;
| | - Rada M. Vučić
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica Street 69, 34000 Kragujevac, Serbia;
| | - Milan Pavlović
- Department of Internal Medicine-Cardiology, Faculty of Medicine, University of Nis, Blvd Zorana Djindjića 81, 18000 Nis, Serbia;
| | - Aleksandra Ignjatović
- Department of Medical Statistics, Faculty of Medicine, University of Nis, Blvd Zorana Djindjica 81, 18000 Nis, Serbia;
| | - Stefan Momčilović
- Plastic and Reconstructive Surgery Clinic, University Clinical Center Nis, Blvd Zorana Djindjica 48, 18000 Nis, Serbia
- Correspondence: ; Tel.: +381-605-263-654
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