ОЦІНКА ЛЕЙКОЦИТАРНИХ МАРКЕРІВ ЗАПАЛЕННЯ, ЗОКРЕМА СПІВВІДНОШЕННЯ НЕЙТРОФІЛІВ ДО ЛІМФОЦИТІВ, У ПАЦІЄНТІВ ІЗ ХРОНІЧНОЮ ІШЕМІЧНОЮ ХВОРОБОЮ СЕРЦЯ

The aim of the study. To analyze the neutrophil-to-lymphocyte ratio (NLR) in assessing the activity of systemic inflammation in patients with chronic ischemic heart disease (IHD).Material and methods. To achieve the study's aim, 120 individuals with verified stable angina of functional class II-III were examined and divided into two groups based on their NLR values. Group 1 included 41 (34.17%) patients with NLR˂2.83, while Group 2 consisted of 79 (65.83%) patients with NLR≥2.83. All patients underwent a comprehensive examination, which included general clinical, anthropometric, and laboratory-instrumental methods. The severity of systemic inflammatory syndrome in the studied patient groups was assessed based on the cellular composition of peripheral blood at the time of hospitalization. Inflammatory leukocyte markers were calculated from the obtained data: neutrophil-to-lymphocyte ratio (NLR); platelet-to-lymphocyte ratio (PLR); monocyte-to-lymphocyte ratio (MLR); systemic immune-inflammation index (SII, platelet × neutrophil /lymphocyte); systemic inflammation response index (SIRI, neutrophil × monocyte /lymphocyte); and aggregate systemic inflammation index (AISI, neutrophils × platelets × monocytes/lymphocytes).Results. Compared to patients in Group 1, those in Group 2 were more frequently diagnosed with stable angina of functional class III (p˂0.001), chronic heart failure stage IIA (p=0.001), stage III hypertension (p=0.001), and obesity (p˂0.001). They also had higher mean systolic blood pressure values (p=0.011) and heart rate (p=0.006). Moreover, more pronounced structural changes in the myocardium and poorer myocardial function were observed in Group 2, as indicated by a lower left ventricular ejection fraction (52.95±0.56 vs. 58.44±0.63%, respectively; p˂0.001). Patients with NLR≥2.83 compared to those with NLR˂2.83 showed increased intima-media thickness in the right (p˂0.001) and left (p=0.023) common carotid arteries, as well as in the right internal carotid artery (p=0.014). Group 2 patients also had significantly higher levels of total cholesterol, triglycerides, low-density lipoproteins, and atherogenic index. Patients with stable angina of functional class II–III and NLR≥2.83 exhibited a more pronounced low-grade systemic inflammation, characterized by increased neutrophil count (p˂0.001) and decreased lymphocyte count (p˂0.001), as well as significantly higher levels of inflammatory leukocyte markers, including NLR (4.03 [3.34;4.97] vs. 2.27 [1.72;2.58]; p˂0.001), PLR (p˂0.001), MLR (p˂0.001), SII (p˂0.001), SIRI (p˂0.001), and AISI (p˂0.001), compared to patients in Group 1.Conclusions. The use of NLR and other leukocyte markers (PLR, MLR, SII, SIRI, AISI) can aid in assessing the activity of systemic inflammation and predicting the severity of IHD, which is of significant clinical importance for improving the diagnosis and treatment of this condition.