Correlation Study Of NLR,PLR And SII With CaFFR In Patients With Chronic Coronary Syndrome

Objective:The aim of this study was to investigate the correlation between neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic immune inflammatory index(SII)and coronary angiographic fractional flow reserve(ca FFR).To explore the predictive value of NLR,PLR and SII in coronary functional ischemia in patients with chronic coronary syndrome(CCS).Method:A total of 204 patients with CCS attending the Department of Cardiology at the First Affiliated Hospital of Dali University from January 2017 to December 2022 were retrospectively included.Patients were admitted to the hospital with relevant blood biochemical tests and coronary angiography(CAG)completed,and ca FFR was used as a quantitative index for coronary functional assessment to assess the severity of functional coronary ischemia.Patients were divided into a ca FFR > 0.80group(109 patients)and a ca FFR ≤ 0.80 group(95 patients)according to the ca FFR measurement.General and laboratory data were collected from all included patients.The correlation between NLR,PLR and SII and ca FFR was investigated using Spearman’s analysis,plotting subject operating characteristic curves(ROC)and developing binary logistic regression models to find independent predictors of functional coronary ischaemia and to assess their predictive efficacy in order to explore the relationship between SII,NLR and PLR and ca FFR.Results:1.The differences between patients in the ca FFR > 0.80 group and those in the ca FFR ≤ 0.80 group were statistically significant(P < 0.05)in terms of NLR,PLR,SII,neutrophils,lymphocytes,platelets,gender,lipoprotein(a),history of hypertension and history of diabetes mellitus.Differences were not statistically significant(P > 0.05)in leukocytes,monocytes,platelet distribution width,mean platelet volume,red blood cell distribution width,haemoglobin,LDL cholesterol,total cholesterol,HDL cholesterol,triglycerides,fasting glucose,urea and creatinine.2.Spearman’s correlation analysis of NLR,PLR and SII with ca FFR showed that NLR(r =-0.457,P < 0.001),PLR(r =-0.323,P < 0.001)and SII(r =-0.500,P< 0.001)were all negatively correlated with ca FFR.3.The working characteristic curves of NLR,PLR,SII and subjects with ca FFR≤0.80 were plotted.NLR,PLR and SII were effective predictors of coronary functional ischemia in patients with CCS,with SII having a higher predictive value than NLR and PLR.the best cut-off value of NLR for predicting coronary functional ischemia in patients with CCS was 2.62,with a sensitivity of 78.9%(AUC: 0.809,95% CI: 0.749-0.868,P < 0.001);PLR predicted functional coronary ischemia with a best cut-off value of 127.1,sensitivity of 86.3%,and specificity of 53.2%(AUC:0.750,95% CI: 0.685-0.816,P < 0.001);the best cut-off value for SII to predict functional coronary ischemia was 611,with a sensitivity of 87.4% and specificity of72.5%(AUC: 0.848,95% CI: 0.796-0.900,P < 0.001).4.Models 1 and 2 were developed based on continuous values of SII and categorical values of SII,respectively.One-way and multi-way logistic regression analyses were performed in two independent models,which showed that SII was an independent predictor of functional ischaemia in the coronary arteries,while diabetes was an independent risk factor(P < 0.05).Conclusions:NLR,PLR and SII,as novel markers of inflammation,were negatively correlated with ca FFR values.Among them,SII is an independent predictor of coronary functional ischaemia in CCS patients,and SII is a better predictor of the severity of coronary functional ischaemia than NLR and PLR.As a simple,easily available and inexpensive biomarker,SII can help clinicians to identify patients at high risk of CCS early,develop individualised treatment plans and improve prognosis.