Background: Coronary artery disease (CAD) is intricately linked to inflammation and atherosclerosis. Neutrophils, key contributors to inflammation, have been associated with CAD development and cardiovascular risk.
Objective: To investigate the potential of the neutrophils to HDL-C ratio (NHR) as a predictor for the severity of coronary artery disease.
Methods: This dual-center, cross-sectional, comparative observational study was conducted at Benha University Hospitals and Heliopolis Hospital from January 2022 to December 2022. The study included 200 patients scheduled for coronary angiography due to CAD-related symptoms. Based on coronary angiography results, patients were categorized into three groups: CAD+ (n=75) with luminal stenosis ≥ 50% in at least one major coronary artery, CAD- (n=25) with luminal stenosis < 50% in one major coronary artery, and a control group (n=100) with normal coronary angiography.
Results: Diabetes, hypertension, and smoking were more prevalent in CAD+ than CAD- and control groups (All P < 0.05). CAD+ had higher BMI (27.99 Kg/m2), systolic (145.69 mmHg), and diastolic blood pressure (96.53 mmHg) compared to CAD- and control groups (p < 0.001). CAD+ had elevated creatinine, triglycerides, uric acid, neutrophils, eosinophils, and neutrophil to HDL-C ratio (p < 0.001). NHR predicted severe CAD with AUC=0.907. NHR correlated positively with BMI, triglycerides, neutrophils, eosinophils, and Gensini score. Logistic regression showed BMI and NHR were significant predictors of disease severity.
Conclusions: NHR could serve as a valuable marker in risk stratification and clinical decision-making for CAD patients.