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<p>Coronary artery disease (CAD) remains the leading cause of morbidity and mortality worldwide. The SYNTAX score is a validated angiographic tool for assessing CAD complexity. Haematological and biochemical inflammatory indices derived from routine complete blood counts (CBC), such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), monocyte-to-HDL ratio (MHR), and systemic immune-inflammation index (SII), may serve as simple and inexpensive predictors of CAD severity. This cross-sectional study included 491 patients with chronic stable angina undergoing coronary angiography, and lesions were analysed using SYNTAX score I. CBC-based indices (NLR, PLR, LMR, MHR, SII), lipid profile, triglyceride glucose (TyG) index, and hs-CRP were calculated. Correlation between these indices and SYNTAX score was analysed using Spearman’s correlation. The mean age of the study population was 60.4 ± 10.6 years, with hypertension (54.4%) and diabetes (42.0%) being the most prevalent comorbidities. The mean SYNTAX score was 16.5 ± 9.8. Among the haematological indices, NLR showed the strongest positive correlation with SYNTAX score (<i>r</i> = 0.428, <i>p</i> &lt; 0.0001), followed by SII (<i>r</i> = 0.355, <i>p</i> &lt; 0.0001) and hs-CRP (<i>r</i> = 0.322, <i>p</i> &lt; 0.0001). PLR, MHR, LMR, and TyG index demonstrated weak or non-significant associations. Multivariable logistic regression analysis showed that elevated NLR (&gt; 2.5) was significantly associated with high SYNTAX score (&gt; 22). In conclusion, NLR demonstrated the strongest association with angiographic CAD severity, along with SII and hs-CRP, in this cross-sectional cohort. These indices are readily available and may complement clinical assessment and early risk stratification before invasive angiography; however, their predictive utility and routine clinical use require confirmation in prospective studies with multivariable modelling and outcome-based validation.</p>

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Association of Haematological and Biochemical Inflammatory Indices with Angiographic Severity of Coronary Artery Disease in Chronic Stable Angina

  • 期刊论文

  • 发表日期：

    2026年6月16日

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  • Kuldeep Kumar Gaur,
  • Ankit Kumar Yadav,
  • Sojit Tomo,
  • Mayank Yadav,
  • Atul Kaushik,
  • Rahul Choudhary,
  • Surender Deora

摘要

Coronary artery disease (CAD) remains the leading cause of morbidity and mortality worldwide. The SYNTAX score is a validated angiographic tool for assessing CAD complexity. Haematological and biochemical inflammatory indices derived from routine complete blood counts (CBC), such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), monocyte-to-HDL ratio (MHR), and systemic immune-inflammation index (SII), may serve as simple and inexpensive predictors of CAD severity. This cross-sectional study included 491 patients with chronic stable angina undergoing coronary angiography, and lesions were analysed using SYNTAX score I. CBC-based indices (NLR, PLR, LMR, MHR, SII), lipid profile, triglyceride glucose (TyG) index, and hs-CRP were calculated. Correlation between these indices and SYNTAX score was analysed using Spearman’s correlation. The mean age of the study population was 60.4 ± 10.6 years, with hypertension (54.4%) and diabetes (42.0%) being the most prevalent comorbidities. The mean SYNTAX score was 16.5 ± 9.8. Among the haematological indices, NLR showed the strongest positive correlation with SYNTAX score (r = 0.428, p < 0.0001), followed by SII (r = 0.355, p < 0.0001) and hs-CRP (r = 0.322, p < 0.0001). PLR, MHR, LMR, and TyG index demonstrated weak or non-significant associations. Multivariable logistic regression analysis showed that elevated NLR (> 2.5) was significantly associated with high SYNTAX score (> 22). In conclusion, NLR demonstrated the strongest association with angiographic CAD severity, along with SII and hs-CRP, in this cross-sectional cohort. These indices are readily available and may complement clinical assessment and early risk stratification before invasive angiography; however, their predictive utility and routine clinical use require confirmation in prospective studies with multivariable modelling and outcome-based validation.