Markers of Inflammation Detected by a Complete Blood Count are Associated with Coronary Atherosclerosis and Reflect Its Severity

Introduction Atherosclerosis is a chronic inflammatory vascular disease that leads to the formation of atherosclerotic plaques and contributes to the prevalence of coronary artery disease (CAD) and high mortality rates worldwide [1] . Some of the complete blood count (CBC) parameters measured are used as an aid to assess the status, clinical management and prognosis of CAD patients [2-5]. Aim The aim was to assess relationship between CBC readings and CAD severity in stable angina pectoris (SAP) patients. Methods This retrospective study enrolled 166 patients who met inclusion criteria (no comorbidities other than arterial hypertension, dyslipidaemia). CAD was assessed by coronary angiography (CA) or computed tomographic coronary angiography (CCTA). Patients who underwent CA were divided according to CAD severity by Gensini score: from 0 to 11; 12 to 35; more than 35. According to CAD-RADS score: CAD-RADS 0; CAD-RADS 1 and 2; CADRADS 3; CAD-RADS 4 and 5. Systemic inflammatory response index ((SIRI) monocyte-tolymphocyte ratio (MLR) x neutrophil count), systemic immune-inflammation index ((SII) – platelet count x neutrophil-to-lymphocyte ratio (NLR)) and others were calculated. Statistical analysis was performed using Mann-Whitney-U, Kruskal-Wallis, χ2 tests, Spearman correlation coefficient. Results The mean age was 61.4 (10.38) years, 57.8% (n=96) were male. Patients with CAD had lower lymphocyte-to-monocyte ratio (LMR), higher NLR, SIRI, MLR, and SII compared to patients without CAD (p<0.001; p=0.01 for SII), (Table 1). According to CAD severity, NLR, MLR, SII and SIRI values increased and LMR decreased gradually with increasing Gensini score (p<0.001), (Table 2). LMR decreased (p<0.046) and SIRI (p<0.001) increased gradually with increasing CADRADS score, (Table 3). SII (r=0.511, p<0.001), NLR (r=0.567, p<0.001), SIRI (r=0.474, p<0.001), MLR (r=0.356, p<0.001), LMR (r=-0.355, p<0.001) correlated with severity of CAD according to Gensini score. The CAD-RADS score correlated with NLR (r=0.365, p<0.001), LMR (r=-0.454, p<0.001), MLR (r=0.455, p<0.001), SIRI (r=0.522, p<0.001). Conclusions NLR, LMR and SIRI are valuable indicators of inflammation, and SIRI is the best predictor of CAD severity in SAP patients out of all other CBC parameters assessed.