Predictors of poor coronary collateral development in patients with stable coronary artery disease: Neutrophil-to-lymphocyte ratio and platelets

Abstract

Objective: The heterogeneity in the degree of collateralization among patients with coronary artery disease (CAD) remains incompletely under- stood. We evaluated the predictors of poorly developed coronary collateral circulation (CCC) in patients with stable coronary artery disease. Methods: Current study is a retrospective study, consisting of 118 patients with poor CCC and 130 patients with good CCC. We investigated predictors of poor coronary collaterals in a cohort of 248 patients who had high-grade coronary stenosis or occlusion on their angiograms. To classify CCC, we used the Rentrop classification. Results: Patients with poorly developed CCC had significantly higher neutrophil-to-lymphocyte ratio (N/L) compared with those with well- developed CCC, (4.2±2.8 vs. 3±3.1, p=0.001), whereas mean platelet volume, red cell distribution width and uric acid were not significantly dif- ferent. Logistic regression analysis showed that N/L ratio (odds ratio 1.199, 95% confidence interval 1.045-1.375) and serum triglyceride levels [odds ratio (OR)=1.006, 95% confidence interval (CI)=1.001-1.010] were independent predictors of poorly developed CCC. Conclusion: An elevated level of N/L ratio is independently associated with a significant impairment in coronary collateralization. Our findings suggest that N/L ratio is an inexpensive, universally available hematological marker for sufficiency of CCC in patients with stable coronary artery disease.