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Abstract：
OBJECTIVE: Chronic inflammation and dyslipidemia are key risk factors for atherosclerotic cardiovascular diseases. We retrospectively explored the association between the neutrophil to lymphocyte ratio (NLR), the ratio of low-density lipoprotein cholesterol (LDL-C) to high-density lipoprotein cholesterol (HDL-C), and the neutrophil to HDL-C ratio (NHR), and the severity of coronary lesions in patients with acute coronary syndrome (ACS).
METHODS: In June 2023, we selected 1210 patients who were diagnosed with ACS based on chest pain from January 2017 to December 2022. Of these, 1100 patients with abnormal coronary angiography were categorized into the experimental group, and 110 patients with normal coronary angiography were classified as the control group. We collected routine blood tests, lipid profiles, and coronary angiography results at admission (before coronary angiography). Patients were then stratified into a control group (Gensini score = 0) and an experimental group (Gensini score = 0) based on the Gensini score. The experimental group was further divided into a low score group (Gensini score < 69) and a high score group (Gensini score ≥ 69).
RESULTS: 1. Statistically significant differences were observed between the control and experimental groups in terms of gender, age, body mass index (BMI), hypertension, diabetes, smoking history, and counts of neutrophils (NEU), lymphocytes (LYM), monocytes (MON), eosinophils (EOS), red cell distribution width (RDW), total cholesterol (TC), HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR (P<0.05). Furthermore, differences in BMI, hypertension, diabetes, smoking history, NEU, LYM, MON, TC, triglyceride (TG), HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR were significant between the low and high score groups (P<0.05). 2. NEU, LYM, MON, TC, HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR showed significant correlations with the Gensini score (r>0.2, P<0.05), with NLR and LDL-C/HDL-C showing the strongest correlations (r = 0.822, P = 0.000). 3. The Receiver Operating Characteristic (ROC) curve indicated that the combination of NLR and LDL-C/HDL-C had superior sensitivity and specificity in predicting the severity of coronary lesions, with a significant difference (P<0.05). The sensitivity was 87.1%, the specificity was 90.9%, and the cut-off point was 2.04. 4. A predictive model was developed based on the ratio of NLR and LDL-C/HDL-C to the Gensini score. The final model score was calculated as 6.803 + 7.029NLR + 13.079LDL-C/HDL-C (R2 = 0.708).
CONCLUSIONS: Compared to NLR, LDL-C/HDL-C, and NHR, the combined NLR and LDL-C/HDL-C ratio is a more accurate marker for assessing the severity of coronary artery disease in ACS patients. Its convenience and effectiveness make it a promising tool for early assessment, timely risk stratification, and appropriate clinical intervention, ultimately improving clinical outcomes for ACS patients.
METHODS: In June 2023, we selected 1210 patients who were diagnosed with ACS based on chest pain from January 2017 to December 2022. Of these, 1100 patients with abnormal coronary angiography were categorized into the experimental group, and 110 patients with normal coronary angiography were classified as the control group. We collected routine blood tests, lipid profiles, and coronary angiography results at admission (before coronary angiography). Patients were then stratified into a control group (Gensini score = 0) and an experimental group (Gensini score = 0) based on the Gensini score. The experimental group was further divided into a low score group (Gensini score < 69) and a high score group (Gensini score ≥ 69).
RESULTS: 1. Statistically significant differences were observed between the control and experimental groups in terms of gender, age, body mass index (BMI), hypertension, diabetes, smoking history, and counts of neutrophils (NEU), lymphocytes (LYM), monocytes (MON), eosinophils (EOS), red cell distribution width (RDW), total cholesterol (TC), HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR (P<0.05). Furthermore, differences in BMI, hypertension, diabetes, smoking history, NEU, LYM, MON, TC, triglyceride (TG), HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR were significant between the low and high score groups (P<0.05). 2. NEU, LYM, MON, TC, HDL-C, LDL-C, NLR, LDL-C/HDL-C, and NHR showed significant correlations with the Gensini score (r>0.2, P<0.05), with NLR and LDL-C/HDL-C showing the strongest correlations (r = 0.822, P = 0.000). 3. The Receiver Operating Characteristic (ROC) curve indicated that the combination of NLR and LDL-C/HDL-C had superior sensitivity and specificity in predicting the severity of coronary lesions, with a significant difference (P<0.05). The sensitivity was 87.1%, the specificity was 90.9%, and the cut-off point was 2.04. 4. A predictive model was developed based on the ratio of NLR and LDL-C/HDL-C to the Gensini score. The final model score was calculated as 6.803 + 7.029NLR + 13.079LDL-C/HDL-C (R2 = 0.708).
CONCLUSIONS: Compared to NLR, LDL-C/HDL-C, and NHR, the combined NLR and LDL-C/HDL-C ratio is a more accurate marker for assessing the severity of coronary artery disease in ACS patients. Its convenience and effectiveness make it a promising tool for early assessment, timely risk stratification, and appropriate clinical intervention, ultimately improving clinical outcomes for ACS patients.
摘要：
目的：慢性炎症和血脂异常是动脉粥样硬化性心血管疾病的主要危险因素。我们回顾性研究了中性粒细胞与淋巴细胞比率（NLR）之间的关联，低密度脂蛋白胆固醇（LDL-C）与高密度脂蛋白胆固醇（HDL-C）的比值，和中性粒细胞与HDL-C的比率（NHR），和急性冠脉综合征（ACS）患者冠脉病变的严重程度。
方法：在2023年6月，我们选择了2017年1月至2022年12月基于胸痛诊断为ACS的1210例患者。其中,1100例冠状动脉造影异常患者分为实验组,将110例冠状动脉造影正常的患者归为对照组。我们采集了血常规,脂质分布，入院时（冠状动脉造影前）的冠状动脉造影结果。然后根据Gensini评分将患者分为对照组（Gensini评分=0）和实验组（Gensini评分=0）。实验组又分为低评分组(Gensini评分<69)和高评分组(Gensini评分≥69)。
结果：1.在性别方面，对照组和实验组之间观察到统计学上的显着差异。年龄,体重指数（BMI），高血压,糖尿病,吸烟史,和中性粒细胞（NEU）计数，淋巴细胞（LYM），单核细胞（MON），嗜酸性粒细胞（EOS），红细胞分布宽度(RDW)，总胆固醇(TC),HDL-C,LDL-C,NLR,LDL-C/HDL-C,和NHR(P<0.05)。此外，BMI的差异，高血压,糖尿病,吸烟史,NEU,LYM,MON,TC,甘油三酯（TG），HDL-C,LDL-C,NLR,LDL-C/HDL-C,和NHR在低评分组和高评分组之间有显著性差异(P<0.05)。2.NEU,LYM,MON,TC,HDL-C,LDL-C,NLR,LDL-C/HDL-C,NHR与Gensini评分呈显著相关(r>0.2,P<0.05),NLR与LDL-C/HDL-C相关性最强(r=0.822,P=0.000)。3.受试者工作特征(ROC)曲线显示,NLR和LDL-C/HDL-C联合预测冠状动脉病变严重程度具有较高的敏感性和特异性。差异有统计学意义(P<0.05)。灵敏度为87.1%,特异性为90.9%，截止点是2.04。4.基于NLR和LDL-C/HDL-C与Gensini评分的比率开发了预测模型。最终模型评分计算为6.803+7.029NLR+13.079LDL-C/HDL-C(R2=0.708)。
结论：与NLR相比，LDL-C/HDL-C,和NHR,联合NLR和LDL-C/HDL-C比值是评估ACS患者冠状动脉疾病严重程度的更准确的指标.它的便捷性和有效性使其成为早期评估的有希望的工具，及时进行风险分层，和适当的临床干预，最终改善ACS患者的临床结局。
方法：在2023年6月，我们选择了2017年1月至2022年12月基于胸痛诊断为ACS的1210例患者。其中,1100例冠状动脉造影异常患者分为实验组,将110例冠状动脉造影正常的患者归为对照组。我们采集了血常规,脂质分布，入院时（冠状动脉造影前）的冠状动脉造影结果。然后根据Gensini评分将患者分为对照组（Gensini评分=0）和实验组（Gensini评分=0）。实验组又分为低评分组(Gensini评分<69)和高评分组(Gensini评分≥69)。
结果：1.在性别方面，对照组和实验组之间观察到统计学上的显着差异。年龄,体重指数（BMI），高血压,糖尿病,吸烟史,和中性粒细胞（NEU）计数，淋巴细胞（LYM），单核细胞（MON），嗜酸性粒细胞（EOS），红细胞分布宽度(RDW)，总胆固醇(TC),HDL-C,LDL-C,NLR,LDL-C/HDL-C,和NHR(P<0.05)。此外，BMI的差异，高血压,糖尿病,吸烟史,NEU,LYM,MON,TC,甘油三酯（TG），HDL-C,LDL-C,NLR,LDL-C/HDL-C,和NHR在低评分组和高评分组之间有显著性差异(P<0.05)。2.NEU,LYM,MON,TC,HDL-C,LDL-C,NLR,LDL-C/HDL-C,NHR与Gensini评分呈显著相关(r>0.2,P<0.05),NLR与LDL-C/HDL-C相关性最强(r=0.822,P=0.000)。3.受试者工作特征(ROC)曲线显示,NLR和LDL-C/HDL-C联合预测冠状动脉病变严重程度具有较高的敏感性和特异性。差异有统计学意义(P<0.05)。灵敏度为87.1%,特异性为90.9%，截止点是2.04。4.基于NLR和LDL-C/HDL-C与Gensini评分的比率开发了预测模型。最终模型评分计算为6.803+7.029NLR+13.079LDL-C/HDL-C(R2=0.708)。
结论：与NLR相比，LDL-C/HDL-C,和NHR,联合NLR和LDL-C/HDL-C比值是评估ACS患者冠状动脉疾病严重程度的更准确的指标.它的便捷性和有效性使其成为早期评估的有希望的工具，及时进行风险分层，和适当的临床干预，最终改善ACS患者的临床结局。
