The neutrophil-lymphocyte ratio (NLR) is believed to be associated with the complexity of coronary artery disease (CAD). We aim to investigate the association between the NLR and severity of CAD using the SYNTAX scoring system among adult Filipinos.Design and Method:
This is a cross-sectional study conducted at a tertiary hospital. The NLR of included patients, taken within 1 week prior to the angiogram, was computed (neutrophil divided by lymphocyte count). After coronary angiogram, the severity of CAD was determined independently, using the SYNTAX scoring system. The primary outcome was presence of severe CAD represented by a SYNTAX score of > 32.Results:
A total of 211 patients with a mean age of 57 years were included. Diagnosis after coronary angiogram was 1-Vessel CAD in 64 (30%), 2-Vessel CAD in 34 (16%), and 3-Vessel CAD in 66 (31%). 46 patients (22%) were found to have severe CAD based on a SYNTAX score of > 32. The NLR, neutrophil, and lymphocyte count correlated with SYNTAX score using Pearson's correlation coefficient. The optimal cutoff value of NLR to predict high syntax score is 2.51. On multiple logistic regression, only the NLR (OR 6.98, p < 0.001) and smoking history (5.84, p 0.002) were associated with a SYNTAX score > 32.Conclusions:
Among adult Filipinos with angina suspected of CAD, the NLR is a useful, inexpensive tool to predict severity of multi-vessel disease using the SYNTAX scoring system. A cut-off NLR of 2.51 may be used to stratify patients with a high NLR and predict the presence of severe CAD (SYNTAX > 32).