Ragab A Mahfouz, Tamer Mostafa and Dalia S Fahmy
Aim: The aim of the present study was to investigate the impact of Neutrophil-Lymphocyte Ratio (NLR) on Coronary Flow Reserve (CFR) and incipient myocardial dysfunction in patients with Psoriatic Arthritis (PsA) without risk for coronary artery disease.
Methods and results: We analyzed clinical, hematologic, echocardiographic and CFR data of 68 patients (mean age 41.5 ± 8.2years), who had no risk factor for coronary artery disease. Sixty-two healthy subjects were served as control group. NLR was significantly higher in patients with PsA versus control subjects (7.86 ± 0.6 vs. 1.39 ± 0.6, P<0 .0001). CFR was significantly lower in patients with PsA than in control subjects (1.9 ± 0.3 vs. 3.6 ± 0.2; P <0.002). The myocardial function was significantly impaired in patients than control subjects (E/E’ was 12.3 + 0.7 vs. 5.3 ± 0.8; P<0.01 and Sm was 3.9 ± 0.3 vs. 8.9 ± 0.5; P<0.01). NLR was significantly negatively correlated with CFR (r=- 0.73, P<0.0001); Sm (r=0.43; P<0.03), and positively correlated with E/E’ (r=0.57; P<0.001). Using multiple logistic regression analysis, NLR, and C-reactive protein levels emerged as independent predictors of impaired CFR, elevated E/E’ and decreased Sm. In receiver operating characteristics curve analysis, NLR ≥ 3.2 and ≥ 3.6 were the cut-offs in predicting impaired CFR and increased E/E’ in patients with PsA.
Conclusion: High NLR is a powerful and independent predictor of impaired CFR and incipient myocardial dysfunction in patients with psoriasis arthritis.