NEUTROPHILS TO LYMPHOCYTE RATIO AS A BIOMARKER OF CORONARY ARTERY DISEASE

SHAMS TABREZ*, MOHAMMED NABILALAMA**, NASIMUDEEN R. JABIR*, CHELAPRAM K. FIROZ*

*King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia - **Cardiology Unit, Department of Medicine, King Abdulaziz University Hospital, Jeddah 21589, Saudi Arabia

Introduction: Cardiovascular disease is the leading contributor of global death. Because of steadily expanding ascend in death rate, the earnest need is to discover novel prognostic biomarkers. In this attempt, inflammation has been a prominent target because of its importance in the development and behavior of atherosclerotic plaques. The current article came up from the recent suggestions by the scientific community on the role of neutrophils to lymphocyte ratio (NLR) as an inflammatory predictive biomarker of cardiovascular events at an early stage.

Materials and methods: Blood samples were collected from 100 chronic coronary artery disease (CAD) patients who have visited the outpatient department (OPD) at King Abdulaziz University Hospital, Jeddah, Saudi Arabia and 100 healthy control individuals. Complete blood examination was done on Cell-Dyn Ruby, USA to calculate NLR. In addition, lipid profile, platelet counts, red cell distribution width (RDW), C-reactive proteins (CRP), fasting glucose, insulin and glycosylated hemoglobin (HbA1c) were also measured by various procedures on different instruments.

Results: Total cholesterol and low-density lipoproteins (LDL) showed a significant rise of around 13%. However, non-highdensity lipoprotein cholesterol (Non-HDL) level showed a similar decline (P<0.05) compared with control. A remarkable rise in fasting glucose, Hb1Ac, and insulin by 58%, 53%, and 44% was recorded in CAD group. Moreover, CRP level also showed a significant rise of 39% in CAD group compared with control individuals. The white blood cell (WBC) analysis revealed a significant enhancement in total WBC, neutrophils and lymphocytes counts. The calculated NLR was found to be significantly (P<0.001) elevated by 110% in CAD patients compared with control individuals.

Conclusions: In view of significant enhancement of NLR level in our samples, we recommend its use as a predictive biomarker of CAD because it is a simple and inexpensive method and could be performed in a routine blood sample.