The Value Of Neutrophil To Lymphocyte Ratio(NLR)and Platelet To Lymphocyte Ratio(PLR)in Evaluating The Degree Of Coronary Artery Stenosis And The Occurrence Of Major Cardiovascular Adverse Events(MACE)in Patients With Acute Coronary Syndrome(ACS)

Objective: To investigate the relationship between neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)and the degree of coronary artery stenosis,the occurrence of major cardiovascular adverse event(MACE)in patients with acute coronary syndrome(ACS).Methods:Collected complete demographic,clinical data and laboratory parameters of 426 ACS patients who underwent coronary angiography for the first time in our hospital from 2018-04 to 2020-04.According to the presence of in-hospital MACE,the included patients were divided into MACE group(n=104)and non-MACE group(n=322).According to the tertiles of Gensini scores,patients were divided into three groups: low Gensini group(<34 points,n=143),medium Gensini group(34-58 points,n=142),and high Gensini group(>58 points,n=141).The data were analyzed by t test,variance analysis,chi-square test,non-parametric Mann-whitney U test,kruskal-wallish H test,logistic regression analysis,and receiver operating characteristic curve.Results:The NLR and PLR values of the MACE group were significantly higher than those of the non-MACE group(4.48[2.42,7.47]vs2.82 [1.79,4.70],Z=-4.071,P<0.001;133.21[92.88,190.25]vs101.03 [75.33,134.01],Z =-5.103,P<0.001).Further,there were significant differences in NLR and PLR among the tertiles of GS(3.59[1.56,3.58]vs3.47[1.94,5.73]vs3.71[2.13,6.21]P<0.001;93.98[66.03,127.94]vs110.9[88.26,140.79]vs120.37[84.58,174.54],P<0.001).NLR and PLR were independent risk factors of in-hospital MACE(OR:1.189,95%CI:1.003-1.409,P=0.046;.OR:0.993,95% CI:0.986-0.999,P=0.021)and severe CAD assessed by the GS(OR 1.102,95%CI 1.005～1.208,P=0.039;OR 1.004,95%CI 1.002～1.009,P=0.042).The cut-off value of NLR predicted the occurrence of MACEs in the hospital was 4.5161,sensitivity was 50%,and specificity was 74.530%(area under curve [AUC]:0.633,95%CI:0.585-0.679,P<0.001).The cut-off value of PLR in predicting MACEs in hospital was 153.103,sensitivity 45.19%,specificity 84.78%(AUC: 0.666,95%CI: 0.619-0.711,P<0.001).NLR predicted high Gensini(>58 points)with an cut-off point of 3.802,a sensitivity of 49.620%,and a specificity of 66.440%(AUC:0.600,95%CI :0.552-0.647,P<0.001).PLR predicted high Gensini with an cut-off point of 153.543,a specificity of 84.750%(AUC:0.616,95%CI :0.567-0.662,P<0.001).Conclusion:As new inflammatory markers,NLR and PLR have significant independent correlation with the occurrence of MACE and the severity of coronary stenosis in ACS patients.As readily available and inexpensive inflammatory markers,NLR and PLR can be widely used as effective inflammatory markers to identify high-risk patients.Thus,it is helpful to guide the individualized treatment to improve the prognosis of ACS.