Association between preoperative neutrophil lymphocyte ratio and coronary collateral circulation

Aim: Coronary collateral circulation (CCC) helps to protect and preserve myocardium from episodes of ischemia, reduce angina symptoms, arrhythmia and cardiovascular events. Although neutrophil lymohocyte ratio (NLR) have been associated with prognosis in patients with various cardiovascular diseases, the data concerning its relationship with coronary collateral circulation (CCC) in patients with coronary artery disease (CAD) is limited. Therefore, in the current study we aimed to investigate whether preoperative NLR is associated with CCC. Methods: A total of 165 patients (mean age: 61,18 ± 10,57 years, 127 male) who underwent coronary angiography were retrospectively enrolled into this study. Development of CCC was classified using the method of Rentrop. Rentrop grades of 0 and 1 indicate poor CCC, whereas grades 2 and 3 indicate good CCC. Hematological parameters, including NLR, were measured. Multivariate logistic regression analysis was performed to identify independent variables. Results: The mean age, Gensini score, smoking rate were significantly higher in the good CCC group. Total cholesterol and low density lipoprotein levels were significantly lower in the good CCC group. The mean neutrophil level and NLR were significantly higher in the good CCC group compared with the poor CCC group. The CCC grade showed significant correlation with neutrophil and NLR. After multivariate analysis, high level of NLR, Gensini score and smoking were independent predictors of good CCC. The receiver-operating characteristic analysis provided a cutoff value of 3,53 for NLR to predict good CCC with 37,6% sensitivity and 85% specificity. Conclusion: The results suggest that NLR is associated with good CCC, and a high NLR is a significant predictor of good CCC development in patients with CAD.