Hematological indices in patients with varying degrees of coronary artery atherosclerosis

Despite the successes of preventive cardiology associated with effective impact on modifiable risk factors of heart diseases, the main cause of death worldwide remains coronary heart disease. The development of atherosclerosis is based on the violation of lipid metabolism and local inflammation of the vascular wall. Hematological indexes may be new marker in predicting the severity of atherosclerotic lesion of the coronary arteries.

Purpose. To compare the hematological indices in patients with atherosclerosis of the coronary arteries of varying severity.

Material and methods. The study included 88 patients who were divided into three groups: without coronary artery atherosclerosis (n = 31), with non-stenotic coronary artery atherosclerosis (n = 26), and with stenotic coronary artery atherosclerosis (n = 31). The average age of the patients was 58.5±7.9 years. The following hematological parameters were determined: NLR (neutrophil-lymphocyte ratio), PLR (platelet-lymphocyte ratio), MLR (monocyte-lymphocyte ratio), SII (systemic inflammation index). SIRI (Index of systemic inflammatory response). The data obtained was processed using the statistical packages Excel, Statistica 10.0.

Results. The SIRI hematological index was significantly higher in the group of patients with coronary artery stenosis compared with patients with non-stenosing coronary artery atherosclerosis (1.20 (0.96; 1.74) and 0.85 (0.66; 1.21), respectively, p < 0.007) and patients without coronary artery atherosclerosis (1.20 (0.96; 1.74) and 0.77 (0.54; 1.21), respectively, p < 0.002). The NLR was also higher in the group of patients with stenotic coronary artery atherosclerosis compared to patients without coronary artery atherosclerosis (2.03 (1.67; 2.74) and 1.54 (1.33; 2.03), respectively, p < 0.007).

Conclusion. Hematological indexes, along with traditional risk factors, can become promising and economically accessible biomarkers in routine practice, used in the prediction of the severity of coronary atherosclerosis and the stratification of cardiovascular risk. The introduction of the use of hematological indexes as additional criteria of prognostic models is of scientific and practical interest and requires further study.

1. WHO reveals leading causes of death and disability worldwide: 2000–2019. World Health Organization. Available from: https://www.who.int/news/item/09-12-2020-who-reveals-leading-causes-of-death-and-disability-worldwide-2000-2019.

2. Ridker P.M., Rane M. Interleukin-6 signaling and anti-interleukin-6 therapeutics in cardiovascular disease. Circ Res. 2021, vol. 128(11), pp. 1728–1746. doi: 10.1161/CIRCRESAHA.121.319077.

3. Zahar’jan EA, Ibragimova RJ. Neutrophil-lymphocyte ratio in patients with coronary heart disease. Ural Medical Journal. 2023, vol. 22(1), pp. 51–56. doi: 10.52420/2071-5943-2023-22-1-51-56. (Russian).

4. Sharma K., Patel A.K., Shah K.H., Konat A. Is neutrophil-to-lymphocyte ratio a predictor of coronary artery disease in Western Indians? Int J Inflam. 2017, vol. 2017. doi: 10.1155/2017/4136126.

5. Park J.B. Neutrophil-to-lymphocyte ratio for risk assessment in coronary artery disease and carotid artery atherosclerosis. J Cardiovasc Ultrasound. 2016, vol. 24(2), pp. 104–105. doi: 10.4250/jcu.2016.24.2.104.

6. Kaya H., Ertaş F., İslamoğlu Y. et al. Association between neutrophil to lymphocyte ratio and severity of coronary artery disease. Clin Appl Thromb Hemost. 2014, vol. 20(1), pp. 50–54. doi: 10.1177/1076029612452116.

7. Tamhane U.U., Aneja S., Montgomery D. et al. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol. 2008, vol. 102(6), pp. 653–657. doi: 10.1016/j.amjcard.2008.05.006.

8. Akboga M.K., Canpolat U., Yayla C. et al. Association of platelet to lymphocyte ratio with inflammation and severity of coronary atherosclerosis in patients with stable coronary artery disease. Angiology. 2016, vol. 67(1), pp. 89–95. doi: 10.1177/0003319715583186.

9. Yüksel M., Yıldız A., Oylumlu M. et al. The association between platelet/lymphocyte ratio and coronary artery disease severity. Anatol J Cardiol. 2015, vol. 15(8), pp. 640–647. doi: 10.5152/akd.2014.5565.

10. Xia Y., Xia C., Wu L. et al. Systemic Immune Inflammation Index (SII), System Inflammation Response Index (SIRI) and Risk of All-Cause Mortality and cardiovascular mortality: a 20-year follow-up cohort study of 42,875 US adults. J Clin Med. 2023, vol. 12(3), pp. 1128. doi: 10.3390/jcm12031128.

11. Erdoğan M., Erdöl M.A., Öztürk S., Durmaz T. Systemic immune-inflammation index is a novel marker to predict functionally significant coronary artery stenosis. Biomark Med. 2020, 14(16), pp. 1553–1561. doi: 10.2217/bmm-2020-0274.

12. Liu Y., Ye T., Chen L. et al. Systemic immune-inflammation index predicts the severity of coronary stenosis in patients with coronary heart disease. Coron Artery Dis. 2021, vol. 32(8), pp. 715–720. doi: 10.1097/MCA.0000000000001037.

13. Shvarts V.A., Talibova S.M., Sokolskaya M.A. et al. Association of novel biomarkers of systemic inflammation with atherosclerosis and its severity. Russian Journal of Cardiology. 2024, vol. 29(8), pp. 67–74. doi: 10.15829/1560-4071-2024-6025. (Russian).