The Correlation Between Neutrophil/Lymphocyte Ratio And Slow Coronary Flow

Objective:This study analyzed the general conditions and laboratory data of patients with slow coronary flow(SCF)and patients with normal coronary artery,including blood sugar,blood lipids,liver and kidney function,blood cell composition,etc.Explore the important risk factors for the occurrence of SCF and the correlation between neutrophil/lymphocyte ratio(NLR)and SCF,to provide a new simple and easy inflammatory index for the clinical diagnosis,treatment and prevention of SCF patients.Methods:This study is a retrospective study.226 patients who underwent coronary artery angiograghy(CAG)at Fuwai Cardiovascular Hospital in Yunnan Province due to chest pain from January 1st,2018 to October 1st,2020.Arteriography showed that there was slow coronary blood flow phenomenon but the coronary arteries had no obvious disease(coronary artery stenosis rate<40%).82 patients were regarded as the slow coronary flow group(SCF group).Rrandomly selected to show that the coronary angiography was completely normal 144 cases served as the control group(NCF group).Collect basic data for all selected candidates:gender,age,height,weight,admission blood pressure,admission pulse,history of tobacco and alcohol,history of basic diseases,medication;laboratory data:white blood cell(WBC),neutrophils(Neut),lymphocytes(Lym),monocytes(Mono),eosinophils(Eo),red blood cells(RBC),hemoglobin(Hb),red blood cell distribution width(RDW),platelets(PLT),platelet distribution width(PDW),glycosylated hemoglobin,fasting blood glucose,total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),serum creatinine(Cr),uric acid(UA),urea nitrogen(BUN),ejection fraction(EF),high-sensitivity cardiac troponin I(hs-cTnI),myoglobin(MYO),creatine kinase-MB(CK-MB),N terminal pro B type natriuretic peptide(NT-proBNP).According to blood routine calculation and analysis of NLR value,lymphocyte/monocyte ratio(LMR),platelet/lymphocyte ratio(PLR),monocyte/high-density lipoprotein cholesterol(MHR),total cholesterol/high-density lipoprotein cholesterol(TC/HDL-C),triglyceride/high density lipoprotein cholesterol(TG/HDL-C),compare the differences in indicators between the two groups.Binary logistic regression was used to analyze the risk factors of SCF.Receiver operating characteristic(ROC)curve analysis was used to determine the best cut-off value of SCF diagnosed by NLR.P<0.05 means there is a significant statistical difference.Results:1.Compared with the NCF group,the SCF group had a higher proportion of males,history of hyperlipidemia,smoking history,BMI,Cr,UA,BUN,WBC,Neut,RBC,Hb,NLR,and taking antiplatelet drugs(P<0.05);In contrast,the level of PLT was lower(P<0.05).2.Multivariate logistic regression analysis showed:Male(ZP=0.013,OR=3.48,95%CI=1.29-9.34)、BMI(P=0.018,OR=1.11,95%CI=1.02-1.21)are the important risking factors for patients with slow coronary flow.3.ROC analysis found that the optimal threshold for NLR to predict SCF patients is 1.39,the sensitivity and specificity are 84.1%and 34.0%,and the area under the curve(AUC)is 0.584(95%CI:0.508-0.660,P=0.036).Conclusions:1.Compared with NCF patients,the level of NLR is higher in SCF patients.2.Male and obesity are the important risking factors for slow coronary flow.3.When the NLR value is used as an index to predict the occurrence of SCF,it has acceptable sensitivity but low specificity.