YE Shiyong,LYU Lingchun,HU Wuming, et al. Correlation between neutrophil-lymphocyte ratio and fractional flow reserve in patients with coronary intermediate lesions and its clinical value[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2024, 54(9): 725-731.
Abstract：Objective: To investigate the correlation between neutrophil-lymphocyte ratio (NLR) and fractional llow reserve (FFR) in patients with coronary intermediate lesions and to assess the clinical value of
NLR in predicting coronary artery ischemia. Methods: The clinical data from 105 stable coronary heart disease patients with coronary intermediate lesions (50%-70% stenosis) confirmed by coronary angiography at the Fifth Affiliated Hospital of Wenzhou Medical University from January 2022 to August 2023 was retrospectively analyzed. Peripheral venous blood was collected before coronary angiography to calculate NLR, and FFR was measured during coronary angiography. Based on FFR results, patients were categorized into FFR<0.8 (indicating physiological ischemia) and FFR≥0.8 group. General clinical and laboratory data were compared between the two groups. Pearson correlation analysis, restricted cube spline (RCS), multivariate Logistic regression analysis,and ROC curve were employed to assess the correlation between NLR and FFR and the predictive clinical value of NLR for coronary physiological ischemia. Results: Patients in the FFR<0.8 group exhibited significantly higher rate of diabetes history, total white blood cell count, neutrophil count, NLR, and hsCRP compared with the FFR≥0.8 group. Meanwhile, lymphocyte count in the FFR<0.8 group was notably lower (all P<0.05). Pearson correlation analysis revealed a negative correlation between NLR and FFR (r=-0.447, P<0.001). RCS analysis
demonstrated an overall association between NLR and the presence or absence of coronary physiological ischemia (P=0.001), without non-linear correlation (P=0.123). After adjusting for confounding factors, multivariate Logistic regression analysis indicated that NLR independently predicted FFR<0.8 in patients with coronary intermediate lesions (OR=4.101, 95%CI=2.002-8.403, P<0.001). ROC curve analysis identified the optimal NLR cut-off point for FFR<0.8 as 2.34, with a sensitivity of 80.90%, specificity of 79.30%, and an area under the curve of 0.814 (95%CI=0.734-0.894). Conclusion: NLR demonstrates a negative correlation with FFR, offering valuable predictive insights into the physiological ischemia of coronary intermediate lesions. It holds high reference value for guiding therapeutic planning in such cases.
