Relationship between neutrophil-lymphocyte ratio and severity of lower extremity peripheral artery disease

Jacob Teperman, David Carruthers, Yu Guo, Mallory P. Barnett, Adam A. Harris, Steven P. Sedlis, Michael Pillinger, Anvar Babaev, Cezar Staniloae, Michael Attubato, Binita Shah

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Background The aim of this study was to determine the association between neutrophil-lymphocyte ratio (NLR) and severity of lower extremity peripheral artery disease (PAD). Methods A retrospective chart review identified 928 patients referred for peripheral angiography. NLR was assessed from routine pre-procedural hemograms with automated differentials and available in 733 patients. Outcomes of interest were extent of disease on peripheral angiography and target vessel revascularization. Median follow-up was 10.4 months. Odds ratio (OR) [95% confidence intervals] was assessed using a logistic regression model. Results There was a significant association between elevated NLR and presence of severe multi-level PAD versus isolated suprapopliteal or isolated infrapopliteal disease (OR 1.11 [1.03–1.19], p = 0.007). This association remained significant even after adjustment for age (OR 1.09 [1.01–1.17], p = 0.02); age, sex, race, and body mass index (OR 1.08 [1.00–1.16], p = 0.046); and age, sex, race, body mass index, hypertension, diabetes mellitus, coronary artery disease, and creatinine (OR 1.07 [1.00–1.15], p = 0.049). After additional adjustment for clinical presentation, there was a trend towards association between NLR and severe multi-level PAD (OR 1.07 [1.00–1.15], p = 0.056), likely limited by sample size. In patients who underwent endovascular intervention (n = 523), there was no significant difference in rate of target vessel revascularization across tertiles of NLR (1st tertile 14.8%, 2nd tertile 14.1%, 3rd tertile 20.1%; p = 0.32). Conclusion In a contemporary cohort of patients undergoing peripheral angiography with possible endovascular intervention, elevated NLR was independently associated with severe multi-level PAD. Larger studies evaluating the association between this inexpensive biomarker and clinical outcomes are warranted.

Original languageEnglish (US)
Pages (from-to)201-204
Number of pages4
JournalInternational Journal of Cardiology
Volume228
DOIs
StatePublished - Feb 1 2017
Externally publishedYes

Keywords

  • Lymphocyte
  • Neutrophil
  • Peripheral angiography
  • Peripheral artery disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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