Jacob Teperman1, David Carruthers1, Yu Guo2, Mallory P Barnett1, Adam A Harris1, Steven P Sedlis3, Michael Pillinger4, Anvar Babaev1, Cezar Staniloae1, Michael Attubato1, Binita Shah5. 1. Department of Medicine, Division of Cardiology, NYU School of Medicine, 550 First Avenue, New York, NY 10016, USA. 2. Department of Population Health, Division of Biostatistics, NYU School of Medicine, 550 First Avenue, New York, NY 10016, USA. 3. Department of Medicine, Division of Cardiology, NYU School of Medicine, 550 First Avenue, New York, NY 10016, USA; Department of Medicine, Section of Cardiology, VA New York Harbor Health Care Center, 423 E 23rd St, New York, NY 10010, USA. 4. Department of Medicine, Section of Rheumatology, VA New York Harbor Health Care Center, 423 E 23rd St, New York, NY 10010, USA; Department of Medicine, Division of Rheumatology, NYU School of Medicine, 550 First Avenue, New York, NY 10016, USA. 5. Department of Medicine, Division of Cardiology, NYU School of Medicine, 550 First Avenue, New York, NY 10016, USA; Department of Medicine, Section of Cardiology, VA New York Harbor Health Care Center, 423 E 23rd St, New York, NY 10010, USA. Electronic address: binita.shah@nyumc.org.
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 10.4months. 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. Published by Elsevier Ireland Ltd.
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 10.4months. 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. Published by Elsevier Ireland Ltd.
Authors: Emil Marian Arbănași; Adrian Vasile Mureșan; Cătălin Mircea Coșarcă; Réka Kaller; Theodor Ioan Bud; Ioan Hosu; Septimiu Toader Voidăzan; Eliza Mihaela Arbănași; Eliza Russu Journal: Life (Basel) Date: 2022-05-31