Kadriye Memiç Sancar, Serkan Kahraman, Seda Tükenmez Karakurt, Meltem Tekin, Büşra Çörekcioğlu, Alkım Ateşli, Hulusi Satılmışoğlu, Gökhan Demirci, Mustafa Yıldız

Clinic of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training Research Hospital,İstanbul, Turkey

Keywords: Coronary artery disease; percutaneous coronary intervention; neutrophils; lymphocytes; mortality


Introduction: This study aimed to investigate pre-procedural (Neutrophil to Lymphocyte Ratio) (NLR) in patients with (Left Main Coronary Artery) (LMCA) disease and to identify a relevant NLR value related to mortality after percutaneous intervention in unprotected LMCA disease.

Patients and Methods: Seventy-one patients diagnosed with unprotected LMCA disease were divided into two groups according to their mortality rates: survivors (n= 56, 78%) and non-survivors (n= 15, 22%). The mean follow-up duration was 26.0 ± 24.8 months, and all-cause mortality was considered as an endpoint.

Results: The non-survivor group had higher NLR values [3.23 (2.31-4.01) vs. 5.82 (2.92-14.99), p= 0.026] compared to the survivor-group. ROC analysis revealed an NLR cut-off value of 5.24 for predicting all-cause mortality. During follow-up, the group with high NLR values was associated with a significantly higher rate of all-cause mortality rate [6 (10.5%) vs. 9 (64.3%), p< 0.001] compared to the low NLR group. In multivariate analysis, the NLR (OR= 1.695; 95% CI= 1.124-2.556; p= 0.012) was found to be independent predictors of mortality.

Conclusion: NLR is the independent predictor of all-cause mortality in unprotected LMCA disease. As far as we know, this study is the first study investigating the prognostic value of NLR in patients with unprotected LMCA disease stenting.

Ethics Committee Approval

The approval for this study was obtained from İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital Clinical Research Ethics Committee (Decision no: 2021/46, Date: 08.06.2021).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept/Design - KM, SK, MY; Analysis/Interpretation - SK, KM; Data Collection - BC, AA, GD; Writing - KM, SK, SK; Critical Revision - SK, HS, MY; Final Approval - SK, KM; Overall Responsibility - KM, SK, MY.

Conflict of Interest

The authors declared that there was no conflict of interest during the preparation and publication of this article.

Financial Disclosure

The authors declared that this study has received no financial support.