Comparison of neutrophil to lymphocyte ratio in patients with coronary artery ectasia versus patients with obstructive coronary artery disease.

BACKGROUND Previous studies have demonstrated that inflammation, neurohormonal process and cardiovascular risk factors are associated with the development of coronary artery ectasia (CAE). However, the underlying mechanisms responsible for ectasia formation are not fully understood. The neutrophil to lymphocyte (N/L) ratio has recently emerged as a new inflammation marker for cardiovascular disease. AIM In this study, we hypothesised that CAE could be associated with more severe inflammation compared to obstructive coronary artery disease (O-CAD) with regard to N/L ratio values. METHODS A total of 405 patients with isolated CAE, O-CAD and insignificant CAD (controls) were enrolled. Severity of isolated CAE was determined according to the Markis classification. N/L ratio values were compared between the three groups. RESULTS We determined that the patients with isolated CAE had significantly elevated N/L ratio values compared to O-CAD and control groups (2.5 vs. 1.9, p < 0.001 and vs. 1.6, p < 0.001, respectively). In multivariate analysis adjusted for age, sex, diabetes mellitus (DM) and hypertension, N/L ratio was independently associated with the presence (N/L ratio, OR = 2.48, 95% CI 2.03-3.02, p < 0. 001) and severity (DM, OR = 2.90, 95% CI 1.02-8.18, p = 0.044, N/L ratio, OR = 1.88, 95% CI 1.47-2.41, p = 0.004) of isolated CAE. ROC curve analysis revealed that a N/L ratio value of > 2.06 identified the patients with isolated CAE. CONCLUSIONS We showed that patients with isolated CAE had a significantly higher N/L ratio than patients with O-CAD and control groups. This finding suggests that a more severe inflammatory process could be involved in the development of CAE.