The Neutrophil/Lymphocyte Ratio is Associated with Different Stages of Development of Coronary Artery Disease

Introduction:Inflammation plays a role in coronary artery disease(CAD).The neutrophil/lymphocyte ratio(NLR),monocyte/lymphocyte ratio(MLR)and platelet/lymphocyte ratio(PLR)are blood parameters associated with inflammation.We aimed to perform a systematic comparison and study the predictive values of these inflammatory parameters with respect to CAD stage.Method:A total of 513 patients who had undergone coronary angiography(CAG)were retrospectively analyzed.Clinical status,lipid profiles,CAG scans and hematological parameters were collected.NLR,MLR and PLR were calculated.All patients were classified into a normal coronary group(n=133),coronary atherosclerosis(CA)group(n=149),chronic coronary syndrome(CCS)group(n=175)or acute myocardial infarction(AMI)group(n=56).NLR,MLR and PLR were compared among groups.Results:NLR and MLR were higher in the CCS and AMI groups.PLR was higher in the AMI group.The AMI group had higher NLR,PLR and MLR than the CCS group.Logistic regression analysis revealed that NLR(OR:1.227,95%CI:1.016–1.482.P<0.05)had a strong significant correlation with CAD.Area under the ROC curve of NLR was 0.580(95%CI=0.516–0.644)in predicting CCS and 0.727(95%CI=0.642–0.811)in predicting AMI.Conclusion:NLR may be associated with the occurrence and progression of CAD,and may serve as a marker of inflammation.

Epicardial Adipose Tissue in Patients with Obstructive Sleep Apnea:A Systematic Review and Meta-analysis

Objective:Epicardial adipose tissue(EAT)is a potential risk factor for obstructive sleep apnea(OSA).We performed a meta-analysis to assess the association of EAT with OSA.Methods:The PubMed,EMBASE,Web of Science,Cochrane Library,and Wanfang databases were searched by two independent investigators for all observational studies assessing the association of EAT with OSA.Then we assessed the association of EAT thickness(EAT-t)and EAT volume(EAT-v)with OSA by a meta-analysis.Results:Ten studies were included in the fi nal analysis.Compared with that in controls,EAT-t in OSA patients was signifi cantly increased(standardized mean difference 0.88,95%confi dence interval 0.72-1.05,P=0.000).Furthermore,EAT-t was greater in OSA patients than in controls with similar BMIs.However,we did not fi nd signifi cant differences in EAT-v between OSA patients and controls(standardized mean difference 2.46,95%confi dence interval−0.36 to 5.29,P=0.088).EAT-t in the mild,moderate,and severe OSA subgroups was greater than in the controls.In addition,there were signifi cant differences in EAT-t among the mild,moderate,and severe OSA subgroups.Conclusions:EAT-t was greater in patients with OSA than in controls,and EAT-t was also associated with the severity of OSA.These fi ndings may provide a new clue for the pathogenesis and treatment of OSA.

Spontaneous Coronary Artery Dissection with Iliac Artery Dissection: A Case Report and Literature Review

Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome or sudden cardiac death.It often occurs in females with no conventional cardiovascular risk factors.Bilateral iliac artery dissection is also a rare disease.This case report describes a patient with spontaneous coronary artery dissection and iliac artery dissection.The authors believe that a conservative approach could be used as an effective therapy for a clinically stable patient.