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

Objective: To determine whether an elevated neutrophil-lymphocyte ratio (NLR) is associated with chronically impaired myocardial perfusion in patients with known or suspected coronary disease. Background: Elevated 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. Methods: This 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). Results: NLR 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). Conclusion: An elevated NLR demonstrated strong associations with myocardial perfusion.