The Relationship Between Neutrophil Lymphocyte Ratio And Epicardial Fat Tissue In Patients With Coronary Heart Disease

ObjectiveWith the tremendous changes in people’s living style,the incidence of coronary heart disease is increasing at present.The occurrence of coronary heart disease is related to coronary artery atherosclerosis.Then stenosis or occlusion of the lumen further occurs on the basis of it,leading to myocardial ischemia,hypoxia and other clinical symptoms.Coronary atherosclerosis is mainly related to the following mechanisms,such as endothelial damage,lipid deposition,the increase of monocyte-macrophage and chronic inflammatory response,which in turn lead to the occurrence of coronary heart disease.Other factors such as smoking,drinking,obesity,family history,hyperlipidemia,hyperglycemia and so on are also related to the occurrence of coronary heart disease,in which the role of inflammation is extremely important.Previous studies have found a positive correlation between severity of coronary heart disease and neutrophil to Lymphocyte Ratio.NLR is closely related to the degree of atherosclerosis and calcification score and can predict coronary heart disease and help to diagnose and evaluate the therapeutic effect of coronary heart disease.Thus clinicians can better treat coronary heart disease.It was also found that there was a strong correlation between coronary atherosclerosis and epicardial adipose tissue.Epicardial adipose tissue is a kind of visceral adipose tissue,which mainly surrounds the heart and is closely related to the location of the myocardium in structure.EAT can also affect myocardium and coronary artery by releasing a variety of inflammatory substances,which can cause coronary heart disease.Other studies have found that the thickness of epicardial adipose tissue has great predictive value for the severity of coronary heart disease.The method about how to measure it is simple and has important clinical application value.In conclusion,both NLR and EAT have great predictive value for coronary heart disease.Potential relationships between NLR and EAT volumes in hypertensive patients have been found in the past.However,there is no study on the relationship between NLR and EAT in patients with coronary heart disease.Therefore,the purpose of this paper is to explore the relationship between them in patients with coronary heart disease.MethodThis study selected 69 subjects who were admitted to the Department of Cardiology of Second Affiliated Hospital of Shandong First Medical University from October 2017 to December 2018.All participants were under coronary angiography and coronary computerized tomography angiography examination simultaneously,according to the results of coronary angiography,those whose coronary stenosis is more than 50% were included in the CAD group.Among all of them,20 were males and 11 were females,the other 38 were in the non-CAD group,16 of them were males and 22 were females.The general data and basic laboratory biochemical indicators of the two groups were collected respectively,and the NLR ratio was calculated according to the neutrophil count and lymphocyte count of the laboratory examination,EAT values were measured by certain software according to CTA results of patients,and above all,statistical analysis was carried out by SPSS software.ResultStatistical analysis showed that there were no significant differences in smoking,drinking,hypertension,diabetes mellitus,left atrial diameter,left ventricular ejection fraction,left ventricular posterior wall thickness,interventricular septum thickness,aortic root diameter,total bilirubin,creatinine,blood sugar,blood lipid,low density lipoprotein,high density lipoprotein and beta 2-microglobulin between CHD group and non-CHD group,but there were significant differences in age and BMI(p<0.05).EAT levels in CHD group were significantly higher than those in non-CHD group(124.37±30.26 ml vs98.62±15.16 ml,p<0.01)and there is a significant difference between them.The level of NLR in CAD group was also higher than that of non-CAD group(2.39±0.57vs1.70±0.43,p<0.01),and the difference was significant(p<0.01).Pearson correlation analysis showed that there was a positive relationship between EAT volume and NLR(r = 0.344,p = 0.048)in patients with coronary heart disease,but the result is different in non-CHD group(r =0.146,p = 0.382).Logistic regression analysis showed that NLR and EAT were still independent risk factors for coronary heart disease.The receiver operating characteristic analysis curves of NLR and EAT for predicting coronary heart disease found that a level of EAT of 111.20(p<0.01)predict the CAD with the sensitivity 67.7% and specificity 81.6%,respectively.The maximum area under EAT curve was 0.789,and the 95% confidence interval was(0.673-0.904).A level of NLR of 1.76(P<0.01)predict the CAD with the sensitivity 90.3% and specificity 63.2%,respectively.The maximum area under EAT curve was 0.831,and the 95% confidence interval was(0.739-0.924).ConclusionNLR and EAT are independent risk factors for coronary heart disease,and there is a positive correlation between them.