Relationship between neutrophil-lymphocyte ratio and severity of lower extremity peripheral artery disease

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• 作者：Jacob Teperman^a ; David Carruthers^a ; Yu Guo^b ; Mallory P. Barnett^a ; Adam A. Harris^a ; Steven P. Sedlis^a ; ^c ; Michael Pillinger^d ; ^e ; Anvar Babaev^a ; Cezar Staniloae^a ; Michael Attubato^a ; Binita Shah^a ; ^c ; ^{binita.shah@nyumc.org}
• 关键词：Neutrophil ; Lymphocyte ; Peripheral artery disease ; Peripheral angiography
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：1 February 2017
• 年：2017
• 卷：228
• 期：Complete
• 页码：201-204
• 全文大小：268 K
• 卷排序：228

文摘

The aim of this study was to determine the association between neutrophil-lymphocyte ratio (NLR) and severity of lower extremity peripheral artery disease (PAD).MethodsA retrospective chart review identified 928 patients referred for peripheral angiography. NLR was assessed from routine pre-procedural hemograms with automated differentials and available in 733 patients. Outcomes of interest were extent of disease on peripheral angiography and target vessel revascularization. Median follow-up was 10.4 months. Odds ratio (OR) [95% confidence intervals] was assessed using a logistic regression model.ResultsThere was a significant association between elevated NLR and presence of severe multi-level PAD versus isolated suprapopliteal or isolated infrapopliteal disease (OR 1.11 [1.03–1.19], p = 0.007). This association remained significant even after adjustment for age (OR 1.09 [1.01–1.17], p = 0.02); age, sex, race, and body mass index (OR 1.08 [1.00–1.16], p = 0.046); and age, sex, race, body mass index, hypertension, diabetes mellitus, coronary artery disease, and creatinine (OR 1.07 [1.00–1.15], p = 0.049). After additional adjustment for clinical presentation, there was a trend towards association between NLR and severe multi-level PAD (OR 1.07 [1.00–1.15], p = 0.056), likely limited by sample size. In patients who underwent endovascular intervention (n = 523), there was no significant difference in rate of target vessel revascularization across tertiles of NLR (1st tertile 14.8%, 2nd tertile 14.1%, 3rd tertile 20.1%; p = 0.32).ConclusionIn a contemporary cohort of patients undergoing peripheral angiography with possible endovascular intervention, elevated NLR was independently associated with severe multi-level PAD. Larger studies evaluating the association between this inexpensive biomarker and clinical outcomes are warranted.