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A novel marker of inflammation in patients with slow coronary flow: lymphocyte-to-monocyte ratio

    Çağrı Yayla

    *Author for correspondence:

    E-mail Address: cagriyayla@gmail.com

    Türkiye Yüksek Ihtisas Training & Research Hospital, Cardiology Clinic, Ankara, Turkey

    ,
    Mehmet Kadri Akboğa

    Türkiye Yüksek Ihtisas Training & Research Hospital, Cardiology Clinic, Ankara, Turkey

    ,
    Kadriye Gayretli Yayla

    Dışkapı Yıldırım Beyazıt Training & Research Hospital, Cardiology Clinic, Ankara, Turkey

    ,
    Ahmet Göktuğ Ertem

    Türkiye Yüksek Ihtisas Training & Research Hospital, Cardiology Clinic, Ankara, Turkey

    ,
    Tolga Han Efe

    Dışkapı Yıldırım Beyazıt Training & Research Hospital, Cardiology Clinic, Ankara, Turkey

    ,
    Fatih Şen

    Türkiye Yüksek Ihtisas Training & Research Hospital, Cardiology Clinic, Ankara, Turkey

    ,
    Sefa Ünal

    Türkiye Yüksek Ihtisas Training & Research Hospital, Cardiology Clinic, Ankara, Turkey

    ,
    Burak Açar

    Türkiye Yüksek Ihtisas Training & Research Hospital, Cardiology Clinic, Ankara, Turkey

    ,
    Fırat Özcan

    Türkiye Yüksek Ihtisas Training & Research Hospital, Cardiology Clinic, Ankara, Turkey

    ,
    Osman Turak

    Türkiye Yüksek Ihtisas Training & Research Hospital, Cardiology Clinic, Ankara, Turkey

    &
    Özcan Özeke

    Türkiye Yüksek Ihtisas Training & Research Hospital, Cardiology Clinic, Ankara, Turkey

    Published Online:https://doi.org/10.2217/bmm-2016-0022

    Aim: Recently, lymphocyte-to-monocyte ratio (LMR) has emerged as a new indirect marker of inflammation which is associated with adverse outcomes in oncology and cardiovascular diseases. The aim of the study was to evaluate the relationship between LMR and slow coronary flow (SCF). Patients & methods: A total of 100 consecutive patients with SCF and 100 consecutive patients with normal coronary flow were enrolled in this study. Results: LMR was significantly lower in patients with SCF than in patients with normal coronary flow (p < 0.001). Also, LMR was negatively correlated with neutrophil-to-lymphocyte ratio and CRP levels (p < 0.001 and p = 0.005). LMR was found to be significantly and independently associated with SCF (p = 0.033). Conclusion: LMR was negatively correlated with serum C-reactive protein and neutrophil-to-lymphocyte ratio levels.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

    References

    • 1 Tambe AA, Demany MA, Zimmerman HA, Mascarenhas E. Angina pectoris and slow flow velocity of dye in coronary arteries – a new angiographic finding. Am. Heart. J. 84(1), 66–71 (1972). • This was the first study that identified the slow coronary flow (SCF).
    • 2 Goel PK, Gupta SK, Agarwal A, Kapoor A. Slow coronary flow: a distinct angiographic subgroup in syndrome X. Angiology 52(8), 507–514 (2001).
    • 3 Gokce M, Kaplan S, Tekelioglu Y, Erdogan T, Kucukosmanoglu M. Platelet function disorder in patients with coronary slow flow. Clin. Cardiol. 28(3), 145–148 (2005).
    • 4 Li JJ, Xu B, Li ZC, Qian J, Wei BQ. Is slow coronary flow associated with inflammation? Med. Hypotheses 66(3), 504–508 (2006). • Showed that inflammation related with SCF.
    • 5 Dogan M, Akyel A, Cimen T et al. Relationship between neutrophil to lymphocyte ratio and slow coronary flow. Clin. Appl. Thromb. Hemost. 21(3), 251–254 (2015). • This was the first study that neutrophil-to-lymphocyte ratio related with SCF.
    • 6 Turhan H, Saydam GS, Erbay AR et al. Increased plasma soluble adhesion molecules; ICAM-1, VCAM-1, and E-selectin levels in patients with slow coronary flow. Int. J. Cardiol. 108(2), 224–230 (2006).
    • 7 Horne BD, Anderson JL, John JM et al. Which white blood cell subtypes predict increased cardiovascular risk? J. Am. Coll. Cardiol. 45(10), 1638–1643 (2005).
    • 8 Nunez J, Minana G, Bodi V et al. Low lymphocyte count and cardiovascular diseases. Curr. Med. Chem. 18(21), 3226–3233 (2011).
    • 9 Van Der Laan AM, Hirsch A, Robbers LF et al. A proinflammatory monocyte response is associated with myocardial injury and impaired functional outcome in patients with ST-segment elevation myocardial infarction: monocytes and myocardial infarction. Am. Heart. J. 163(1), 57 e52–65 e52 (2012).
    • 10 Maekawa Y, Anzai T, Yoshikawa T et al. Prognostic significance of peripheral monocytosis after reperfused acute myocardial infarction:a possible role for left ventricular remodeling. J. Am. Coll. Cardiol. 39(2), 241–246 (2002). • Showed that monocytosis associated with atherosclerotic coronary disease.
    • 11 Hu P, Shen H, Wang G, Zhang P, Liu Q, Du J. Prognostic significance of systemic inflammation-based lymphocyte- monocyte ratio in patients with lung cancer: based on a large cohort study. PLoS ONE 9(9), e108062 (2014).
    • 12 Han LH, Jia YB, Song QX, Wang JB, Wang NN, Cheng YF. Prognostic significance of preoperative lymphocyte-monocyte ratio in patients with resectable esophageal squamous cell carcinoma. Asian Pac. J. Cancer Prev. 16(6), 2245–2250 (2015).
    • 13 Murat SN, Yarlioglues M, Celik IE et al. The Relationship between lymphocyte-to-monocyte ratio and bare-metal stent in-stent restenosis in patients with stable coronary artery disease. Clin. Appl. Thromb. Hemost. doi:10.1177/1076029615627340 (2016) (Epub ahead of print). •• This was the first study demonstrating lymphocyte-to-monocyte ratio as a prognostic marker of cardiovascular events in patients with stable coronary artery disease.
    • 14 Kurtul A, Yarlioglues M, Celik IE et al. Association of lymphocyte-to-monocyte ratio with the no-reflow phenomenon in patients who underwent a primary percutaneous coronary intervention for ST-elevation myocardial infarction. Coron. Artery. Dis. 26(8), 706–712 (2015).
    • 15 Gibson CM, Cannon CP, Daley WL et al. TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation 93(5), 879–888 (1996).
    • 16 Stone GW, Brodie BR, Griffin JJ et al. Prospective, multicenter study of the safety and feasibility of primary stenting in acute myocardial infarction: in-hospital and 30-day results of the PAMI stent pilot trial. Primary Angioplasty in Myocardial Infarction Stent Pilot Trial Investigators. J. Am. Coll. Cardiol. 31(1), 23–30 (1998).
    • 17 Xu Y, Meng HL, Su YM et al. Serum YKL-40 is increased in patients with slow coronary flow. Coron. Artery. Dis. 26(2), 121–125 (2015).
    • 18 Cetin MS, Ozcan Cetin EH, Canpolat U et al. An overlooked parameter in coronary slow flow phenomenon: whole blood viscosity. Biomark. Med. 9(12), 1311–1321 (2015).
    • 19 Hutterer GC, Sobolev N, Ehrlich GC et al. Pretreatment lymphocyte-monocyte ratio as a potential prognostic factor in a cohort of patients with upper tract urothelial carcinoma. J. Clin. Pathol. 68(5), 351–355 (2015).
    • 20 Yue S, Zhang J, Wu J, Teng W, Liu L, Chen L. Use of the monocyte-to-lymphocyte ratio to predict diabetic retinopathy. Int. J. Environ. Res. Public. Health. 12(8), 10009–10019 (2015).
    • 21 Gary T, Pichler M, Belaj K et al. Lymphocyte-to-monocyte ratio: a novel marker for critical limb ischemia in PAOD patients. Int. J. Clin. Pract. 68(12), 1483–1487 (2014).
    • 22 Kounis NG, Hahalis G. White blood cell counts in predicting cardiovascular events: the racial ratios. Coron. Artery. Dis. 26(5), 369–371 (2015).
    • 23 Kounis NG, Soufras GD, Tsigkas G, Hahalis G. White blood cell counts, leukocyte ratios, and eosinophils as inflammatory markers in patients with coronary artery disease. Clin. Appl. Thromb. Hemost. 21(2), 139–143 (2015).
    • 24 Widmer A, Linka AZ, Attenhofer Jost CH et al. Mechanical complications after myocardial infarction reliably predicted using C-reactive protein levels and lymphocytopenia. Cardiology 99(1), 25–31 (2003).
    • 25 Ommen SR, Gibbons RJ, Hodge DO, Thomson SP. Usefulness of the lymphocyte concentration as a prognostic marker in coronary artery disease. Am. J. Cardiol. 79(6), 812–814 (1997).
    • 26 Ommen SR, Hodge DO, Rodeheffer RJ, Mcgregor CG, Thomson SP, Gibbons RJ. Predictive power of the relative lymphocyte concentration in patients with advanced heart failure. Circulation 97(1), 19–22 (1998).
    • 27 Mohler ER 3rd. Mechanisms of aortic valve calcification. Am. J. Cardiol. 94(11), 1396–1402 (2004).
    • 28 Lambert JM, Lopez EF, Lindsey ML. Macrophage roles following myocardial infarction. Int. J. Cardiol. 130(2), 147–158 (2008).
    • 29 Tapp LD, Shantsila E, Wrigley BJ, Pamukcu B, Lip GY. The CD14++CD16+ monocyte subset and monocyte-platelet interactions in patients with ST-elevation myocardial infarction. J. Thromb. Haemost. 10(7), 1231–1241 (2012).