Association between neutrophil–lymphocyte ratio and impaired myocardial perfusion in patients with known or suspected coronary disease

ObjectiveTo determine whether an elevated neutrophil–lymphocyte ratio (NLR) is associated with chronically impaired myocardial perfusion in patients with known or suspected coronary disease.BackgroundElevated NLRs are positively associated with cardiac events, anatomic coronary disease, and myocardial infarct size. However, no study has evaluated the association between NLR and chronically impaired myocardial perfusion.MethodsThis study included 683 patients undergoing cardiac positron emission tomography (PET) with a calculable NLR within 90 days of PET. The primary outcome was myocardial perfusion defect size measured in percent of left ventricular mass (%LV60).ResultsNLR was independently associated with %LV60 when analyzed as both a continuous and binary outcome (p < 0.001). Individuals with NLR above the 90th percentile had a 5-fold increased likelihood of significant perfusion defects compared to individuals with NLR between the 10th and 25th percentiles (Odds ratio = 4.7, p < 0.001).ConclusionAn elevated NLR demonstrated strong associations with myocardial perfusion.