Correlation of Neutrophyl-Lymphocyte Ratio, Vessel Score based on Sullivan Scoring System, and Troponin in Acute Coronary Syndrome Patients
Downloads
Acute Coronary Syndrome (ACS) is one of the highest causes of death globally, with the number of deaths reaching more than 9 million people in 2016. Therefore, a fast and accurate ACS diagnosis is needed. This study aimed to determine the relationship between the neutrophil-lymphocyte ratio, the number of coronary artery lesions evaluated by angiography, and troponin I in ACS patients Material and Methods: This research is an analytic observational with a retrospective cross-sectional design. Sampling was carried out using a total sampling technique and obtained 87 samples that met the inclusion and exclusion criteria for the 2019-2020 period at Dr. Soetomo Regional General Hospital Surabaya. The correlation between the number of coronary artery lesions and the neutrophil-lymphocyte ratio to troponin I levels were respectively analyzed using chi-square and spearman-rho with SPSS ver. 25. Results: The results showed a moderately significant correlation between the neutrophil-lymphocyte ratio and troponin I levels (p =0.003, rs = 0.319). While the correlation analysis between the number of coronary artery lesions and the vessel score on troponin I showed insignificant results (p = 0.525), which means that the number of coronary artery lesions was not correlated with troponin I. Conclusion: This study concludes a significant correlation with moderate correlation between the neutrophil-lymphocyte ratio and troponin I. However, there is no significant correlation between the number of coronary artery lesions assessed by the Sullivan and troponin I levels.
Achar S. A., Kundu S., Norcross W. A. 2005. Diagnosis of acute coronary syndrome. American Family Physician, 72;1:119–126.
Alfakry, H., Sinisalo, J., Paju, S., Nieminen, M., Valtonen, V., Tervahartiala, T., et al. 2012. The Association of Serum Neutrophil Markers and Acute Coronary Syndrome. Scandinavian Journal of Immunology, 76;2:181-187.
Amsterdam, E., Wenger, N., Brindis, R., Casey, D., Ganiats, T., Holmes, D., et al. 2014. 2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes. Journal of the American College of Cardiology, 64;24:139-228.
Apriliani, D. 2019. Hubungan antara Derajat Stenosis Arteri Koroner dan Kadar Troponin I pada Pasien Infark Miokard Akut di RSUP Dr . Hasan Sadikin Bandung Periode Januari 2018 sampai September 2019, pp. 226–231.
Azab, B., Chainani, V., Shah, N. and McGinn, J., 2012. Neutrophil–Lymphocyte Ratio as a Predictor of Major Adverse Cardiac Events Among Diabetic Population. Angiology, 64;6:456-465.
Bäck, M., Yurdagul, A., Tabas, I., Öörni, K. and Kovanen, P., 2019. Inflammation and its resolution in atherosclerosis: mediators and therapeutic opportunities. Nature Reviews Cardiology, 16;7:389-406.
Balta, S., Celik, T., Mikhailidis, D.P., Ozturk, C., Demirkol, S., Aparci, M., et al. 2016. The relation between atherosclerosis and the neutrophil–lymphocyte ratio. Clinical and applied thrombosis/hemostasis, 22;5:405-411.
Cardoso, M., Silva Junior, D., Ribeiro, E. and Rocha Neto, A., 2018. Correlation Between the Complexity of Coronary Lesions and High-Sensitivity Troponin Levels in Patients with Acute Coronary Syndrome. International Journal of Cardiovascular Sciences, 31;3:218.
Chistiakov, D., Bobryshev, Y. and Orekhov, A., 2015. Heterogeneity of Tregs and the complexity in the IL-12 cytokine family signaling in driving T-cell immune responses in atherosclerotic vessels. Molecular Immunology, 65;1:133-138.
Drechsler, M., Megens, R., van Zandvoort, M., Weber, C. and Soehnlein, O., 2010. Hyperlipidemia-Triggered Neutrophilia Promotes Early Aterosklerosis. Circulation Research, 122;18:1837-1845.
Dur, A., Ismailoglu, Z., Ismailova, M., Akbay, D., Uysal, O., Metin, H., et al. 2017. Relationships Among Markers of Inflammation, Neutrophil-to-Lymphocyte Ratio, and Syntax Severity Score in the Early Phase of Acute Coronary Syndrome. Bezmialem Science, 5;2:56-60.
Fathil, M., Md Arshad, M., Gopinath, S., Hashim, U., Adzhri, R., Ayub, R., et al. 2015. Diagnostics on acute myocardial infarction: Cardiac troponin biomarkers. Biosensors and Bioelectronics, 70:209-220.
Herter, J. and Zarbock, A., 2013. Integrin Regulation during Leukocyte Recruitment. The Journal of Immunology, 190;9:4451-4457.
Ionita, M., van den Borne, P., Catanzariti, L., Moll, F., de Vries, J., Pasterkamp, G., et al. 2010. High Neutrophil Numbers in Human Carotid Atherosclerotic Plaques Are Associated With Characteristics of Rupture-Prone Lesions. Arteriosclerosis, Thrombosis, and Vascular Biology, 30;9:1842-1848.
Iriana D, Nurulita A, Rauf D. 2019. Hubungan kadar troponin I dan high-sensitivity troponin I dengan angiografi koroner pada pasien suspek coronary artery disease : studi di Rumah Sakit Umum Pusat dr . Wahidin Sudirohusodo Makassar-Indonesia tahun 2017. 10;2:420.
Kafkas, N., Demponeras, C., Zoubouloglou, F., Spanou, L., Babalis, D. and Makris, K. 2012. Serum Levels of Gelatinase Associated Lipocalin as Indicator of the Inflammatory Status in Coronary Artery Disease. International Journal of Inflammation, 2012, pp.1-8.
Khan, M., 2016. Comparison Between Angiographic Findings of Coronary Artery Disease in STEMI and NSTEMI Patients of Bangladesh. Journal of the American College of Cardiology, 71;16:S11-S12.
Korkmaz, A., Yildiz, A., Gunes, H., Duyuler, S. and Tuncez, A., 2014. Utility of Neutrophil–Lymphocyte Ratio in Predicting Troponin Elevation in the Emergency Department Setting. Clinical and Applied Thrombosis/Hemostasis, 21;7:667-671.
Laufer, E., Mingels, A., Winkens, M., Joosen, I., Schellings, M., Leiner, T., et al. 2010. The Extent of Coronary Atherosclerosis Is Associated With Increasing Circulating Levels of High Sensitive Cardiac Troponin T. Arteriosclerosis, Thrombosis, and Vascular Biology, 30;6:1269-1275.
Libby, P., Ridker, P. and Hansson, G., 2009. Inflammation in Aterosklerosis. Journal of the American College of Cardiology, 54;23:2129-2138.
Lintermans, L., Stegeman, C., Heeringa, P. and Abdulahad, W., 2014. T Cells in Vascular Inflammatory Diseases. Frontiers in Immunology, p.5.
Mahajan, N., Mehta, Y., Rose, M., Shani, J. and Lichstein, E., 2006. Elevated troponin level is not synonymous with myocardial infarction. International Journal of Cardiology, 111;3:442-449.
Ndrepepa, G., Braun, S., Schulz, S., Mehilli, J., Schömig, A. and Kastrati, A., 2011. High-Sensitivity Troponin T Level and Angiographic Severity of Coronary Artery Disease. The American Journal of Cardiology, 108;5:639-643.
Oztürk, S., Erdem, A., Fatih Ozlü, M., Ayhan, S., Erdem, K., Ozyaşar, M., et al. 2013. Assessment of the neutrophil to lymphocyte ratio in young patients with acute coronary syndromes. Turk Kardiyoloji Dernegi Arsivi-Archives of the Turkish Society of Cardiology, 41;4:284-289.
Rittersma, S.Z., van der Wal, A.C., Koch, K.T., Piek, J.J., Henriques, J.P., Mulder, K.J., et al. 2005. Plaque instability frequently occurs days or weeks before occlusive coronary thrombosis: a pathological thrombectomy study in primary percutaneous coronary intervention. Circulation, 111;9:1160-1165.
Samman Tahhan, A., Sandesara, P., Hayek, S., Hammadah, M., Alkhoder, A., Kelli, H., et al. 2018. High"Sensitivity Troponin I Levels and Coronary Artery Disease Severity, Progression, and Long"Term Outcomes. Journal of the American Heart Association, 7;5.
Soehnlein, O., 2012. Multiple Roles for Neutrophils in Aterosklerosis. Circulation Research, 110; 6:875-888.
Sullivan, D., Marwick, T. and Freedman, S., 1990. A new method of scoring coronary angiograms to reflect extent of coronary atherosclerosis and improve correlation with major risk factors. American Heart Journal, 119;6:1262-1267.
Taleb, S., Romain, M., Ramkhelawon, B., Uyttenhove, C., Pasterkamp, G., Herbin, O., et al. 2009. Loss of SOCS3 expression in T cells reveals a regulatory role for interleukin-17 in aterosklerosis. Journal of Experimental Medicine, 206;10:2067-2077.
Tamhane, U., Aneja, S., Montgomery, D., Rogers, E., Eagle, K. and Gurm, H., 2008. Association Between Admission Neutrophil to Lymphocyte Ratio and Outcomes in Patients With Acute Coronary Syndrome. The American Journal of Cardiology, 102;6:653-657.
World Health Organization (WHO).,2018. Global Health Estimates 2016: Deaths by Cause, Age, Sex, by Country and by Region, 2000- 2016 [online] Available at:
<https://www.who.int/healthinfo/global_burden_disease/estimates/en/> [Accessed 16 April 2020].
Yadav, P., Joseph, D., Joshi, P., Sakhi, P., Jha, R.K. and Gupta, J., 2010. Clinical profile & risk factors in acute coronary syndrome. National J Comm Med, 1;2:150-151.
Zhang Y., Gu W., Sun B., 2014. Th1/Th2 Cell Differentiation and Molecular Signals. In: Sun B. (eds) T Helper Cell Differentiation and Their Function. Advances in Experimental Medicine and Biology, 841.
Copyright (c) 2022 Chelssi Gloria Tessari, Achmad Lefi, Yetti Hernaningsih
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
- Cardiovascular and Cardiometabolic Journal (CCJ) is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License
-
Authors who publish with Cardiovascular and Cardiometabolic Journal (CCJ) agree to the following terms:
-
The journal allows the author to hold the copyright of the article without restrictions.
-
The journal allows the author(s) to retain publishing rights without restrictions.
-
The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution ShareAlike 4.0 International License (CC BY-SA).
