The Value Of Neutrophil To Lymphocyte Ratio And CHA2DS2-VASc-HSF Score In Predicting The Severity Of Coronary Artery Disease

Objective:The aim of this study is to discuss the relationship between(neutrophil to lymphocyte ratio,NLR;CHA2DS2-VASc-HSF score)and the severity of coronary artery disease;the ability of(neutrophil to lymphocyte ratio,NLR;CHA2DS2-VASc-HSF score)to predict the severity of coronary artery disease.Method: 380 patients were enrolled in the research who were admitted in Department of Cardiology,the First Affiliated Hospital of Bengbu Medical College and suspected to suffer from coronary heart disease with chest tightness or chest pain and from January 2016 to May 2016.All patients underwent coronary angiography were divided into CAD group(n=320)and non-CAD group(n=60)according to the result of coronary angiography.All patients accepted blood biochemical examination immediately or next morning after admission.The CAD group was further divided into low value groups(GS score?20 points),median value groups(GS score 20-70 points),high value groups(GS score?70 points)based on the GS score.Analyse the correlation between the(NLR;CHA2DS2-VASc-HSF score)and CAD and the relationship between(NLR;CHA2DS2-VASc-HSF score)and the severity of coronary artery disease measured by Gensini score.All the data were analyzed with SPSS 21.0 software.P value less than 0.05 is considered as statistical significanceResults:1.Compared with control group,patients in CAD group had a higher proportion of men,higher prevalence of hyperlipoidemia,hypertension,diabetes,smoking,heart failure,an older age,the differences were all statistically significant(P<0.05).neutrophil count,NLR,and CHA2DS2-VASc-HSF score were all increased significantly in CAD group compared with control group,and the differences were statistically significant(P < 0.01).2.Compared with low value groups(GS score?20 points),neutrophil count,NLR,CHA2DS2-VASc-HSF score were increased in succession in median value groups(GS score 20-70 points),high value groups(GS score?70 points),however,lymphocyte count were decreased in succession in median value groups(GS score 20-70 points),high value groups(GS score?70 points)and the difference was statistically significant(P=0.000).3.Through logistic regression analysis of risk factors of CAD and high Gensini score,we found in addition to age,hypertion prevalence,smoking and CHA2DS2-VASc-HSF score,NLR is also independent risk factor of CAD(OR=1.361 95%CI:0.874-1.478 P=0.000).Meanwhile,NLR,smoking,and CHA2DS2-VASc-HSF score were independent risk factors of high Gensini score patient(OR=1.241 95%CI0.804-1.318 P=0.000 and OR=2.167 95%CI 1.741-4.697 P=0.012 OR=1.002 95%CI 0.749—1.439 P=0.016)4.Through correlation analysis of white blood cell classification,NLR,and CHA2DS2-VASc-HSF score with Gensini Score using Spearman correlation analysis,we found that neutrophil were positively associated with Gensini Score r=0.639 P=0.000,lymphocytes and Gensini Score negatively correlated with r=-0.535 P=0.000,NLR was positively associated with Gensini Score,r=0.858 P=0.000.CHA2DS2-VASc-HSF score were positively associated with Gensini Score r=0.697 P=0.000 5.Using ROC curve analysis of patients in CAD group,we found that in diagnosis of CAD group,NLR has the largest area under the curve of 0.712(95% confidence interval 0.703-0.775,P=0.000)compared to white blood cell classification and CHA2DS2-VASc-HSF score NLR of 2.62 was the cut point for identification of CAD group,with a specificity of 68.4% and a sensitivity of 72%.CHA2DS2-VASc-HSF score of 4 was the cut point for identification of CAD group,with a specificity of 61.2% and a sensitivity of 66.4%.Conclusion:1.Compared to control group,NLR is significantly higher in bloodsamples of patients with CAD,NLR is independent risk factor of CAD.2.Compared to control group,CHA2DS2-VASc-HSF score is significantly higher in patients with CAD,CHA2DS2-VASc-HSF score is independent risk factor of CAD.3.There is a positive correlation between NLR and Gensini score,the higher of NLR,the more severe of coronary lesion,NLR can predict coronary lesion severity independently.4.There is a positive correlation between CHA2DS2-VASc-HSF score and Gensini score,the higher of CHA2DS2-VASc-HSF score,the more severe of coronary lesion,CHA2DS2-VASc-HSF score can predict coronary lesion severity independently.5.An NLR value above 2.62 and CHA2DS2-VASc-HSF score more than 4 indicate that the more severe coronary artery injury.