Correlation Between Neutrophil To Lymphocyte Ratio,Monocyte To Lymphocyte Ratio And The Premature Coronary Artery Disease

Objective: This study mainly explored whether neutrophil-lymphocyte ratio(NLR)and monocyte-lymphocyte ratio(MLR)are related to the severity of coronary artery disease in patients with premature coronary artery disease.Methods: Collect basic information of all patients who were diagnosed with coronary heart disease due to chest pain from August 2020 to February 2021,and underwent coronary angiography(CAG)at Shaanxi Provincial People’s Hospital and met the age of male <55 years old and female <65 years old.According to strict selection criteria and exclusion criteria,247 cases were selected for retrospective analysis.Among them,153 were males,with an average age of(46.72±6.35)years,and 94 females,with an average age of(53.90±6.36)years.143 cases were diagnosed by CAG in the premature coronary artery disease group,including stable angia pectoris(SAP)47 cases,49 cases in non-ST-elevation acute coronary syndrome(NSTE-ACS)group,47 cases in ST-elevation myocardial infarction(STEMI)group Cases,excluding 104 cases of premature coronary artery disease as the control group.According to the Gensini score of the severity of coronary artery disease,the patients in the premature coronary artery disease group were defined as mild coronary artery disease group with Gensini score<30points,and the severe coronary artery disease group with Gensini score≥30 points.Record the patient’s hospitalization number,name,gender,age,smoking history,drinking history,and disease history,and collect the number of venous white blood cells,neutrophils,lymphocytes,and monocytes of 247 patients at the first admission.The degree of coronary artery disease was evaluated using the American Heart Association Gensini score.Use SPSS 19.0 statistical software for data processing and analysis.Results: 1.Compared with the control group,the levels of NLR and MLR in the premature coronary artery disease group were significantly higher(3.79 vs 2.08,Z =-7.008,P <0.001 and 0.34 vs 0.24,Z =-5.65,P <0.001).2.The levels of NLR and MLR in the premature coronary artery disease group were in the mild coronary artery disease group <severe coronary artery disease group,(2.28 vs 4.86,Z=-5.286,P<0.001 and 0.26 vs 0.40,Z=-3.817,P<0.001).3.According to the clinical classification,it was found that the NLR level was in the STEMI group>NSTE-ACS group>SAP group,the difference was statistically significant(P<0.05);the MLR level was in the STEMI group>NSTE-ACS group and In the SAP group,the difference was statistically significant(P<0.05),but the difference in MLR levels between the NSTE-ACS group and the SAP group was not statistically significant(P>0.05).4.There is a positive correlation between the levels of NLR,MLR and Gensini score(r=0.383,P=0.000;r=0.285,P=0.000).5.Multivariate logistic regression analysis,NLR(OR=1.284,95%CI: 1.067～1.547,P=0.008)and MLR(OR=3.27,95%CI: 2.415～8.585,P=0.026)are Independent risk factors for premature coronary artery disease;NLR(OR=1.180,95%CI: 1.012～1.375,P=0.035)and MLR(OR=2.28,95%CI: 1.434～3.622,P=0.007)are independent risk factors for severe coronary artery disease.6.The cut-off point of NLR for diagnosing premature coronary artery disease is2.28,(sensitivity 74.1%,specificity 63.5%),and the cut-off point of MLR for diagnosing premature coronary artery disease is 0.248,(sensitivity 72%,specificity 56.7%));The cut-off point of NLR for diagnosing severe coronary artery disease is 3.80,(sensitivity64.6 %,specificity 84.1%),and the cut-off point of MLR for diagnosing severe coronary artery disease is 0.30,(sensitivity 67.7%,specificity 65.9%).Conclusion: 1.The levels of NLR and MLR are related to the clinical classification of premature coronary artery disease.The higher the level of NLR and MLR,the more severe the clinical classification of coronary artery disease.However,there was no significant difference in MLR levels between the non-ST-segment elevation acute coronary syndrome group and the stable angina pectoris group.2.The levels of NLR and MLR are positively correlated with the Gensini score of patients with premature coronary artery disease,indicating that the higher the level of NLR and MLR,the more severe the coronary artery disease.3.NLR and MLR are independent risk factors for the diagnosis of the premature coronary artery disease and severe coronary artery disease.