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. 2016 Sep;46(5):699-705.
doi: 10.4070/kcj.2016.46.5.699. Epub 2016 Sep 28.

Association of Neutrophil/Lymphocyte Ratio with Plaque Morphology in Patients with Asymptomatic Intermediate Carotid Artery Stenosis

İsa Öner Yüksel  1 , Erkan Köklü  1 , Şakir Arslan  1 , Göksel Çağırcı  1 , Eylem Özaydın Göksu  2 , Pınar Koç  3 , Serkan Çay  4 , Filiz Kızılırmak  5
Affiliations

Association of Neutrophil/Lymphocyte Ratio with Plaque Morphology in Patients with Asymptomatic Intermediate Carotid Artery Stenosis

İsa Öner Yüksel et al. Korean Circ J. 2016 Sep.

Abstract

Background and objectives: Non-calcified carotid plaques are more unstable than calcified plaques, and they are associated with a higher risk of rupture, thromboembolism, and consequently, stroke. The purpose of the present study is to compare calcified and non-calcified plaques that cause intermediate carotid artery stenosis with respect to neutrophil/lymphocyte ratio (NLR).

Subjects and methods: A total number of 139 asymptomatic patients with 50-70% stenosis of the carotid artery were included in this study. Carotid Doppler ultrasound imaging and computed tomography angiography were performed to divide the carotid artery plaques into two groups as calcified and non-calcified. Patients included in the calcified (n=73) and non-calcified (n=66) plaque groups were compared with respect to total neutrophil count, lymphocyte count and NLR.

Results: Total lymphocyte count was statistically significantly lower in the non-calcified plaque group compared to the calcified plaque group (total lymphocyte count in non-calcified/calcified plaque groups [103/mm3]: 2.1/2.3, respectively) (p=0.002). NLR was statistically significantly higher in the non-calcified plaque group compared to the calcified plaque group (NLR in non-calcified/calcified plaque groups: 2.6/2.1, respectively) (p<0.001). The cut-off value for NLR was found to be >2.54. Multivariate regression analysis showed that NLR was independently associated with non-calcified carotid artery plaques (odds ratio 5.686, 95% CI 2.498-12.944, p<0.001).

Conclusions: NLR is increased in the presence of non-calcified carotid artery plaques that cause asymptomatic intermediate stenosis. Increased NLR can be used as a marker to assess the risk of rupture of non-calcified carotid artery plaques.

Keywords: Atherosclerosis; Atherosclerotic plaque; Carotid artery stenosis; Neutrophil, lymphocyte, ratio; Stroke.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1. Study participants. NSAID : nonsteroidal antiinflammatory drug.
Fig. 2
Fig. 2. Comparison of NLR between the two groups demonstrated that it was statistically significantly higher in the non-calcified plaque group (p<0.001). NLR: neutrophil/lymphocyte ratio.
Fig. 3
Fig. 3. In ROC curve analysis, NLR cut-off value of >2.54 was found for calcified-non calcified plaque discrimination among carotid arteries plaques which caused intermediate obstruction. NLR: neutrophil/lymphocyte ratio, AUC: area under curre.
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