Abstract

Abstract
Background: Ischemic heart diseases are the major burden of global health with significant mortality and morbidity despite tremendous advances in preventative and therapeutic strategies. Patients with Diabetes Mellitus are at higher risk with worse outcomes from cardiovascular diseases. Searching for the underlying causes indicated the association of inflammatory activities with the development of atherosclerotic process in the different stages of coronary artery occlusion. Systemic inflammatory markers can highlight the correlation of inflammatory changes with the extent and severity of coronary artery diseases. Furthermore, prognostic significance of the inflammatory markers is evident in the short- and long-term outcomes of ischemic heart disease patients.
Aim: To investigate the association of NLR and PLR with the severity of coronary artery disease in patients with DM.
Method: A cross-sectional study was done from March 2021 to February 2022 in Basra Cardiac Center, in Basrah, Iraq. Data collection included demographic data, past medical history, complete blood picture including measurement of NLR and PLR, coronary angiography study details including number of diseased vessels, severity and complexity of the lesions and biochemical tests including RBS, renal function test and any others available. 228 patients with CAD admitted for assessment by invasive coronary angiography. The patient enrolled in the study were divided according to the result of coronary angiography into 2 groups; significant (≥70% obstruction) and non-significant CAD (<70% obstruction). Significant CAD is subdivided according to extent into single, double vessel and multi-vessel disease, and according to severity into critical (≥70% obstruction) and total obstruction (100% obstruction). Statistical Package for the Social Sciences version 26.0 (SPSS Inc.) was used for statistical analysis and p-values <0.05 was considered as statistically significant.
Results: The study included 228 (169 males and 59 females) patients with CAD with a mean age of (56.83 ± 11.54). 188 patients had significant CAD when coronary angiography was done. NLR was significantly correlated with the presence, extent and severity of CAD with p-value of (0.01, 0.003, 0.001) respectively. PLR was significantly associated with the severity of CAD (p value = 0.01), but non-significantly correlated with CAD presence or extent with p value of (0.28, 0.36) respectively. Logistic regression analysis showed that NLR, not PLR, was an independent marker to predict significant CAD in patients with DM.
Conclusion: NLR was associated with the presence, extent and severity of significant CAD. PLR was only associated with the severity of CAD. Only NLR was an independent predictor of significant CAD in patients with DM.
Keywords: NLR, PLR, CAD, DM.