scholarly journals Association between Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios and Coronary Artery Calcification Score among Asymptomatic Patients: Data from a Cross-Sectional Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Carlos V. Serrano ◽  
Fernando R. de Mattos ◽  
Fábio G. Pitta ◽  
Cesar H. Nomura ◽  
James de Lemos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Coronary Artery ◽  
Smoking Status ◽  
Statistical Tests ◽  
Low Grade ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Markers Of Inflammation ◽  
Asymptomatic Patients

Introduction. Atherosclerosis is a low-grade inflammatory disease. Among markers of inflammation, importance has been given to the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR). The objective of this study was to examine the association between these hematological indices of inflammation and coronary atherosclerotic calcification in clinically asymptomatic patients. Methods. This study had clinical and laboratorial data collected from consecutive asymptomatic patients that underwent computed tomography coronary artery calcium (CAC) scoring. Risk factors, NLR, and PLR were evaluated at different categories of CAC scoring. Statistical tests included chi-square, linear regression, and logistic regression. Patients (N=247; age 60.4±8.0 years and 60.7% men) were allocated into four categories according to the CAC score. Results. Respective age, sex (male), NLR, and PLR distribution within groups were as follows: CAC=0 (n=98; 52.5±13.6 years, 55%, 2.0±1.0, and 121.5±41.5), CAC 1-100 (N=64; 61.3±11.0 years, 60%, 2.2±1.2, and 125.6 ± 45.6), CAC 101-400 (N=37; 64.2±11.6 years, 67%,2.6±1.3, and 125.4±55.9), and CAC>400 (N=48; 69.3±11.1 years, 66%, 3.3±2.0, and 430.1±1787.4). The association between risk factors and CAC score was assessed. Hypertension status and smoking status were similar within groups, while the presence of diabetes (P=0.02) and older age (P≤0.001) was more prevalent in the CAC>400 group. LDL cholesterol was greater in the higher CAC score groups (P=0.002). Multivariate logistic regression of the quartile analysis showed that age and NLR were independently associated with CAC>100 (OR (CI), P value): 2.06 (1.55-2.73, P=0.00001) and 1.82 (1.33-2.49, P=0.0002), respectively. Conclusion. Within asymptomatic patients, NLR provides additional risk stratification, as an independent association between NLR extent and CAD extent was identified. Moreover, PLR was not an inflammation marker for CAD severity.

scholarly journals Relationship of Neutrophil–Lymphocyte Ratio with coronary artery disease and plaque composition of coronary artery

2021 ◽  
Author(s):  
Ruopeng Wang ◽  
Hui Gu ◽  
Congshan Ji ◽  
Yan Gao ◽  
Lin Gao ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Logistic Regression ◽  
Coronary Artery ◽  
Plaque Burden ◽  
Plaque Composition ◽  
Plaque Volume ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Calcified Plaque ◽  
Artery Disease

Abstract Evidence suggests that the neutrophil-lymphocyte ratio (NLR) has been considered as useful marker for identifying individuals under risk of coronary artery disease (CAD) and associated events, a more powerful predictor than any other leukocyte subtypes. In this study, we aimed to evaluate association of NLR with CAD and plaque composition of coronary artery analyzed from coronary CT angiography (CCTA). The study population consisted of 469 patients who underwent CCTA due to stable typical or atypical chest pain. The enrolled patients were divided into two groups and three groups according to coronary artery stenosis and tertiles of NLR, respectively. The plaque burden, volume and ratio of calcified, lipid and fibrous components of plaques were measured based on CCTA images. Chi-square, Student’s test, ANOVA, Mann–Whitney U test, KruskalWallis test and multiple logistic regression were used for statistical analysis. Compared with non-CAD group, NLR was significantly higher in CAD group(P = 0.001). The non-calcified plaque volume, fibrotic plaque volume and lipid plaque volume increased with the NLR (P༜0.05). Multivariate logistic regression analysis showed that NLR was an independent risk factor for CAD(OR: 1.792, 95CI 1.067–3.011, P < 0.05). The present study demonstrated that NLR is associated with both the CAD and non-calcified plaque volume of coronary artery.

Association of Neutrophil-Lymphocyte Ratio with Mild Cognitive Impairment in Elderly Chinese Adults: A Case-control Study

2020 ◽  
Vol 16 (14) ◽  
pp. 1309-1315
Author(s):  
Peilin An ◽  
Xuan Zhou ◽  
Yue Du ◽  
Jiangang Zhao ◽  
Aili Song ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Predictive Values ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Elderly Chinese ◽  
Normal Cognitive Function ◽  
The Absolute

Background: Inflammation plays a significant role in the pathophysiology of cognitive impairment in previous studies. Neutrophil-lymphocyte ratio (NLR) is a reliable measure of systemic inflammation. Objective: The aim of this study was to investigate the association between NLR and mild cognitive impairment (MCI), and further to explore the diagnostic potential of the inflammatory markers NLR for the diagnosis of MCI in elderly Chinese individuals. Methods: 186 MCI subjects and 153 subjects with normal cognitive function were evaluated consecutively in this study. Neutrophil (NEUT) count and Lymphocyte (LYM) count were measured in fasting blood samples. The NLR was calculated by dividing the absolute NEUT count by the absolute LYM count. Multivariable logistic regression was used to evaluate the potential association between NLR and MCI. NLR for predicting MCI was analyzed using Receiver Operating Characteristic (ROC) curve analysis. Results: The NLR of MCI group was significantly higher than that of subjects with normal cognitive function (2.39 ± 0.55 vs. 1.94 ± 0.51, P < 0.001). Logistic regression analysis showed that higher NLR was an independent risk factor for MCI (OR: 4.549, 95% CI: 2.623-7.889, P < 0.001). ROC analysis suggested that the optimum NLR cut-off point for MCI was 2.07 with 73.66% sensitivity, 69.28% specificity, 74.48% Positive Predictive Values (PPV) and 68.36% negative predictive values (NPV). Subjects with NLR ≥ 2.07 showed higher risk relative to NLR < 2.07 (OR: 5.933, 95% CI: 3.467-10.155, P < 0.001). Conclusion: The elevated NLR is significantly associated with increased risk of MCI. In particular, NLR level higher than the threshold of 2.07 was significantly associated with the probability of MCI.

scholarly journals A comprehensive, contemporary assessment of the association between hepatosteatosis and coronary artery calcium scoring

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
T Heseltine ◽  
SW Murray ◽  
RL Jones ◽  
M Fisher ◽  
B Ruzsics
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Coronary Artery ◽  
Regression Model ◽  
Coronary Artery Calcium ◽  
Logistic Regression Model ◽  
Prediction Models ◽  
Multinomial Logistic Regression ◽  
Cvd Risk ◽  
Male Sex

Abstract Funding Acknowledgements Type of funding sources: None. onbehalf Liverpool Multiparametric Imaging Collaboration Background Coronary artery calcium (CAC) score is a well-established technique for stratifying an individual’s cardiovascular disease (CVD) risk. Several well-established registries have incorporated CAC scoring into CVD risk prediction models to enhance accuracy. Hepatosteatosis (HS) has been shown to be an independent predictor of CVD events and can be measured on non-contrast computed tomography (CT). We sought to undertake a contemporary, comprehensive assessment of the influence of HS on CAC score alongside traditional CVD risk factors. In patients with HS it may be beneficial to offer routine CAC screening to evaluate CVD risk to enhance opportunities for earlier primary prevention strategies. Methods We performed a retrospective, observational analysis at a high-volume cardiac CT centre analysing consecutive CT coronary angiography (CTCA) studies. All patients referred for investigation of chest pain over a 28-month period (June 2014 to November 2016) were included. Patients with established CVD were excluded. The cardiac findings were reported by a cardiologist and retrospectively analysed by two independent radiologists for the presence of HS. Those with CAC of zero and those with CAC greater than zero were compared for demographic and cardiac risks. A multivariate analysis comparing the risk factors was performed to adjust for the presence of established risk factors. A binomial logistic regression model was developed to assess the association between the presence of HS and increasing strata of CAC. Results In total there were 1499 patients referred for CTCA without prior evidence of CVD. The assessment of HS was completed in 1195 (79.7%) and CAC score was performed in 1103 (92.3%). There were 466 with CVD and 637 without CVD. The prevalence of HS was significantly higher in those with CVD versus those without CVD on CTCA (51.3% versus 39.9%, p = 0.007). Male sex (50.7% versus 36.1% p= &lt;0.001), age (59.4 ± 13.7 versus 48.1 ± 13.6, p= &lt;0.001) and diabetes (12.4% versus 6.9%, p = 0.04) were also significantly higher in the CAC group compared to the CAC score of zero. HS was associated with increasing strata of CAC score compared with CAC of zero (CAC score 1-100 OR1.47, p = 0.01, CAC score 101-400 OR:1.68, p = 0.02, CAC score &gt;400 OR 1.42, p = 0.14). This association became non-significant in the highest strata of CAC score. Conclusion We found a significant association between the increasing age, male sex, diabetes and HS with the presence of CAC. HS was also associated with a more severe phenotype of CVD based on the multinomial logistic regression model. Although the association reduced for the highest strata of CAC (CAC score &gt;400) this likely reflects the overall low numbers of patients within this group and is likely a type II error. Based on these findings it may be appropriate to offer routine CVD risk stratification techniques in all those diagnosed with HS.

scholarly journals Patient characteristics of smokers undergoing lumbar spine surgery: an analysis from the Quality Outcomes Database

2017 ◽  
Vol 27 (6) ◽  
pp. 661-669 ◽  
Author(s):  
Anthony L. Asher ◽  
Clinton J. Devin ◽  
Brandon McCutcheon ◽  
Silky Chotai ◽  
Kristin R. Archer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Lumbar Spine ◽  
Smoking Status ◽  
Patient Characteristics ◽  
Lumbar Spine Surgery ◽  
Multivariable Logistic Regression Analysis ◽  
Insurance Status ◽  
Quality Outcomes

OBJECTIVEIn this analysis the authors compare the characteristics of smokers to nonsmokers using demographic, socioeconomic, and comorbidity variables. They also investigate which of these characteristics are most strongly associated with smoking status. Finally, the authors investigate whether the association between known patient risk factors and disability outcome is differentially modified by patient smoking status for those who have undergone surgery for lumbar degeneration.METHODSA total of 7547 patients undergoing degenerative lumbar surgery were entered into a prospective multicenter registry (Quality Outcomes Database [QOD]). A retrospective analysis of the prospectively collected data was conducted. Patients were dichotomized as smokers (current smokers) and nonsmokers. Multivariable logistic regression analysis fitted for patient smoking status and subsequent measurement of variable importance was performed to identify the strongest patient characteristics associated with smoking status. Multivariable linear regression models fitted for 12-month Oswestry Disability Index (ODI) scores in subsets of smokers and nonsmokers was performed to investigate whether differential effects of risk factors by smoking status might be present.RESULTSIn total, 18% (n = 1365) of patients were smokers and 82% (n = 6182) were nonsmokers. In a multivariable logistic regression analysis, the factors significantly associated with patients’ smoking status were sex (p < 0.0001), age (p < 0.0001), body mass index (p < 0.0001), educational status (p < 0.0001), insurance status (p < 0.001), and employment/occupation (p = 0.0024). Patients with diabetes had lowers odds of being a smoker (p = 0.0008), while patients with coronary artery disease had greater odds of being a smoker (p = 0.044). Patients’ propensity for smoking was also significantly associated with higher American Society of Anesthesiologists (ASA) class (p < 0.0001), anterior-alone surgical approach (p = 0.018), greater number of levels (p = 0.0246), decompression only (p = 0.0001), and higher baseline ODI score (p < 0.0001). In a multivariable proportional odds logistic regression model, the adjusted odds ratio of risk factors and direction of improvement in 12-month ODI scores remained similar between the subsets of smokers and nonsmokers.CONCLUSIONSUsing a large, national, multiinstitutional registry, the authors described the profile of patients who undergo lumbar spine surgery and its association with their smoking status. Compared with nonsmokers, smokers were younger, male, nondiabetic, nonobese patients presenting with leg pain more so than back pain, with higher ASA classes, higher disability, less education, more likely to be unemployed, and with Medicaid/uninsured insurance status. Smoking status did not affect the association between these risk factors and 12-month ODI outcome, suggesting that interventions for modifiable risk factors are equally efficacious between smokers and nonsmokers.

scholarly journals The association between neutrophil–lymphocyte ratio and poor outcomes following infant cardiac surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Peng Gao ◽  
Jinping Liu ◽  
Xu Wang ◽  
Peiyao Zhang ◽  
Yu Jin ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Logistic Regression ◽  
Cardiac Surgery ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Time Length ◽  
Mechanical Ventilation Time ◽  
Poor Outcomes

Abstract Background Neutrophil–lymphocyte ratio (NLR) is a valuable indicator for evaluating inflammation and adverse outcomes after cardiac surgery. The objective of this study was to evaluate the association of perioperative NLR with clinical outcomes in infants undergoing congenital heart surgery with cardiopulmonary bypass. Methods We performed a retrospective review of 424 consecutive infants (≤ 1 year) undergoing cardiac surgery between January 2019 and September 2019. Neonates (≤ 28 days) and patients with incomplete NLR data were excluded. The study endpoint was a composite of poor outcomes after surgery. We assess the correlation between perioperative NLR and clinical outcomes. A receiver operating characteristic curve and multivariable logistic regression were applied to identify the prognosis performance of postoperative NLR for poor outcomes. Results A total of 68 (16%) infants experienced at least one of the poor outcomes. Postoperative NLR on the third day after the surgery showed the best prognostic significance (AUC = 0.763, 95%CI 0.700–0.826) among perioperative period, with a cut-off value of 2.05. Postoperative NLR was also strongly correlated with mechanical ventilation time, length of ICU and hospital stay (p < 0.001). Multivariable logistic regression revealed that elevated postoperative NLR (OR 3.722, 95%CI 1.895–7.309, p < 0.001) was an independent risk factor for poor outcomes in infants after cardiac surgery. Conclusions Postoperative NLR was correlated with increased mechanical ventilation time, length of ICU and hospital stay. Elevated postoperative NLR was an independent predictor for poor outcomes after cardiac surgery in infants.

scholarly journals Assessment of the hemogram parameters in patients with paroxysmal supraventricular tachycardia: a retrospective study

2020 ◽  
Vol 66 (10) ◽  
pp. 1371-1375
Author(s):  
Mehmet Cosgun ◽  
Yilmaz Gunes ◽  
Isa Sincer ◽  
Asli Kurtar Mansiroglu
Keyword(s):  
Retrospective Study ◽  
Supraventricular Tachycardia ◽  
University Hospital ◽  
Control Group ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Monocyte Count ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Markers Of Inflammation ◽  
Significant Difference

SUMMARY OBJECTIVE: Inflammation has been suggested as a potential mechanism in the pathogenesis of arrhythmia. Hemogram parameters such as monocyte count to high-density lipoprotein cholesterol ratio (MHR), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) have been considered to be markers of inflammation and new cardiovascular risk predictors. This retrospective study aimed to investigate the relationship between MHR, NLR, and MLR in patients with paroxysmal supraventricular tachycardia (PSVT). METHODS: A retrospective study conducted at a university hospital in Bolu, Turkey, between 2017 and 2019. Our study included 196 patients who underwent electrophysiological study (EPS) due to palpitation or documented PSVT on electrocardiography (ECG). Patients having documented atrioventricular nodal re-entrant tachycardia (AVNRT) on ECG or inducible AVNRT on EPS were included in the PSVT group (n=130), and patients with palpitation but without inducible arrhythmia on EPS (n=66) were included in the control group. Routine biochemical and hemogram tests were performed before the EPS procedure. RESULTS: When hemogram parameters were compared, there was no statistically significant difference in MHR values [0.010 (0.001-0.030) vs 0.010 (0.001-0.020) p =0.67]. Additionally, both NLR [2.21(0.74-11.36) vs 1.98(0.72-24.87) p=0.13] and MLR [0.25 (0.03-1.05) vs 0.24(0.07-1.39) p=0.41] were not statistically significant between the two groups. CONCLUSION: There is no significant difference in PSVT patients regarding hemogram parameters including white blood cell subtypes, MLR, NLR, and MHR. Therefore the evaluation of hemogram parameters may not be clinically relevant for PSVT patients.

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