Baseline characteristics
In present study, 4445 patients who had undergone elective PCI at the Sir Run Run Shaw Hospital between January 2009 and April 2019 were included, according to the inclusion and exclusion criteria. Participants’ median age was 64 (52–71), 71.9% were men, 63.4% had hypertension and 25.6% had diabetes mellitus. Demographic information, laboratory examination and baseline medication can be seen in Table 1.
Table 1
Baseline characteristics of the sample.
| Total samples( n = 4445) |
Age(Years) | 64.00(58.00–71.00) |
Man, N(%) | 3198(71.9%) |
BMI | 24.73(22.64–26.10) |
Current smoking, N(%) | 1131(25.4%) |
Diabetes, N(%) | 1139(25.6%) |
Hypertension, N(%) | 2817(63.4%) |
Previous MI, N(%) | 97(2.2%) |
Previous PCI, N(%) | 217(4.9%) |
Stable angina pectoris | 953(21.4%) |
Laboratory examination | |
NLR | 2.64(1.94–3.95) |
WBC(× 10^9/L) | 6.60(5.40–8.30) |
PLT(× 10^9/L) | 182.00 (149.00-219.63) |
CRP(mg/L) | 1.70(0.70-5.00) |
LDL-C (mmol/L) | 2.22 (1.68–2.93) |
HDL-C (mmol/L) | 1.00(0.84–1.20) |
Lipoprotein(mmol/L) | 15.2(7.78–33.20) |
Total cholesterol(mmol/L) | 4.19(3.47–5.01) |
Triglyceride(mmol/L) | 1.43(1.03–2.04) |
VLDL-C(mmol/L) | 0.62(0.38–0.93) |
Creatinine(µmol/L) | 75.00(64.00-88.40) |
Uric acid(µmol/L) | 356.00(296.00-424.00) |
LDL-C (STDEV) | 0.46(0.26–0.74) |
HDL-C ( STDEV ) | 0.13(0.08–0.19) |
Total cholesterol ( STDEV ) | 0.58(0.35–0.92) |
Triglyceride ( STDEV ) | 0.33(0.19–0.56) |
NLR(mean) | 2.97(2.27–4.11) |
CRP(mean, mg/L) | 1.53(0.80–2.87) |
Baseline medication | |
ACEI, N(%) | 1136(25.6%) |
ARB, N(%) | 1558(35.1%) |
Beta blocker, N(%) | 2600(58.5%) |
CCB, N(%) | 1319(29.7%) |
Aspirin, N(%) | 4284(96.4%) |
Clopidogrel , N(%) | 3602(81.0%) |
Ticagrelor, N(%) | 749(16.9%) |
Ezetimibe, N(%) | 853(19.2%) |
Statin, N(%) | 4377(98.5%) |
Atorvastatin, N(%) | 2687(60.4%) |
Rosuvastatin, N(%) | 1559(35.1%) |
Pravastatin, N(%) | 23(0.5%) |
Simvastatin, N(%) | 58(1.3%) |
Intensive statin treatment, N(%) | 564(12.7%) |
Values are expressed as median (25–75%) or n (%) unless otherwise indicated. STDEV indicates the standard deviation calculated from the follow-up results, mean is the average of the results from the follow-up, NLR neutrophil to lymphocyte ratio, WBC white blood cell, PLT platelet, CRP C-creative protein, BMI Body Mass Index, LDL-C low-density lipoprotein cholesterol, HDL-C high-density lipoprotein cholesterol, VLDL-C very low-density lipoprotein cholesterol, ACEI Angiotensin-Converting Enzyme Inhibitors, ARB angiotensin receptor blocker, CCB calcium channel blocker. |
Results of univariate and multivariate linear regression for the mean of NLR
The univariate analysis suggested that age, gender, diabetes, hypertension, types of statins, HDL-C(STDEV), CRP(MEAN), creatinine and uric acid were all risk factors for the mean value of NLR during follow-up. In contrast, ezetimibe, baseline TC and baseline HDL-C were protective factors for the mean value of NLR (see Table 2).
Table 2
Results of univariate and multivariate linear regression for the mean of NLR
Variable | Univariate regression | Multiple Regression |
ꞵ | SE | p | ꞵ | SE | p |
Age | 0.047 | 0.004 | < 0.001 | 0.035 | 0.004 | < 0.001 |
Gender | 0.366 | 0.092 | < 0.001 | 0.491 | 0.098 | < 0.001 |
Current smoking | -0.029 | 0.048 | 0.547 | | | |
Diabetes | 0.278 | 0.094 | 0.003 | 0.054 | 0.094 | 0.570 |
Hypertension | 0.286 | 0.086 | 0.001 | 0.109 | 0.087 | 0.212 |
Types of statins | 0.317 | 0.051 | < 0.001 | 0.350 | 0.053 | < 0.001 |
Intensive statin treatment | -0.146 | 0.122 | 0.232 | | | |
Ezetimibe | -0.252 | 0.106 | 0.017 | -0.032 | 0.109 | 0.772 |
Baseline TC | -0.109 | 0.033 | 0.001 | -0.182 | 0.050 | < 0.001 |
Baseline LDL-C | -0.019 | 0.042 | 0.657 | | | |
Baseline HDL-C | -0.589 | 0.144 | < 0.001 | -0.266 | 0.162 | 0.101 |
LDL-C (STDEV) | 0.070 | 0.112 | 0.531 | 0.626 | 0.164 | < 0.001 |
HDL-C ( STDEV ) | 4.648 | 0.048 | < 0.001 | 4.008 | 0.503 | < 0.001 |
TC( STDEV ) | 0.069 | 0.089 | 0.438 | | | |
TG( STDEV ) | -0.079 | 0.058 | 0.170 | | | |
CRP(MEAN) | 0.400 | 0.025 | < 0.001 | 0.326 | 0.026 | < 0.001 |
Creatinine | 0.006 | 0.001 | < 0.001 | 0.004 | 0.001 | < 0.001 |
Uric acid | 0.001 | < 0.001 | 0.006 | -0.001 | < 0.001 | 0.087 |
SE indicates standard error, TC total cholesterol, TG triglyceride. Other abbreviations as in Table 1. Level of significance was accepted at 𝑃 < 0.05. |
Once the univariate analysis was corrected to allow for confounding factors, results from the multivariable logistic regression analysis showed that age, gender, types of statins, HDL-C(STDEV), LDL-C(STDEV), CRP(MEAN) and creatinine were all risk factors for the mean value of NLR. Baseline TC was a protective factor for the mean value of NLR (see Table 2).
For HDL-C(STDEV), multivariate linear regression analysis results for each subgroup are stable, showing that HDL-C(STDEV) is a risk factor for the mean value of NLR during the follow-up (see Fig. 1).
In contrast, the relationship between LDL-C(STDEV) and the mean value of NLR was consistent across patients with blood lipid controlled ([ꞵ] 0.643, [95% CI] 0.249–1.037, p-value = 0.001), diabetes ([ꞵ] 1.065, [95% CI] 0.442–1.689, p-value = 0.001), no diabetes ([ꞵ] 0.459, [95% CI] 0.083–0.836, p-value = 0.017), those who were taking statins ([ꞵ] 0.778, [95% CI] 0.430–1.127, p-value < 0.001), taking atorvastatin ([ꞵ] 0.654, [95% CI] 0.255–1.054, p-value = 0.001) and taking rosuvastatin ([ꞵ] 0.504, [95% CI] 0.074–0.934, p-value = 0.022) (see Fig. 2).
Results of univariate and multivariate linear regression for the variability in NLR
The univariate analysis suggested that age, gender, types of statins, HDL-C(STDEV), CRP(MEAN) and creatinine were all risk factors for NLR variability during follow-up. In contrast, baseline TC and baseline HDL-C were protective factors for NLR variability (see Table 3).
Table 3
Results of univariate and multivariate linear regression for variability in NLR
Variable | Univariate regression | Multiple Regression |
ꞵ | SE | p | ꞵ | SE | p |
Age | 0.034 | 0.004 | < 0.001 | 0.024 | 0.005 | < 0.001 |
Gender | 0.303 | 0.102 | 0.003 | 0.320 | 0.108 | 0.003 |
Current smoking | -0.057 | 0.054 | 0.289 | | | |
Diabetes | 0.125 | 0.105 | 0.232 | | | |
Hypertension | 0.099 | 0.095 | 0.298 | | | |
Types of statins | 0.261 | 0.056 | < 0.001 | 0.304 | 0.061 | < 0.001 |
Intensive statin treatment | -0.143 | 0.136 | 0.293 | | | |
Ezetimibe | -0.214 | 0.117 | 0.068 | | | |
Baseline TC | -0.079 | 0.036 | 0.029 | -0.175 | 0.055 | 0.002 |
Baseline LDL-C | 0.008 | 0.047 | 0.859 | | | |
Baseline HDL-C | -0.553 | 0.160 | 0.001 | -0.381 | 0.185 | 0.040 |
LDL-C (STDEV) | 0.194 | 0.124 | 0.120 | 0.660 | 0.183 | < 0.001 |
HDL-C ( STDEV ) | 4.680 | 0.533 | < 0.001 | 4.328 | 0.578 | < 0.001 |
TC( STDEV ) | 0.168 | 0.099 | 0.089 | | | |
TG( STDEV ) | 0.003 | 0.064 | 0.964 | | | |
CRP(MEAN) | 0.321 | 0.029 | < 0.001 | 0.256 | 0.030 | < 0.001 |
Creatinine | 0.005 | 0.001 | < 0.001 | 0.003 | 0.001 | < 0.001 |
Uric acid | 0.001 | < 0.001 | 0.093 | | | |
SE indicates standard error, TC total cholesterol, TG triglyceride. Other abbreviations as in Table 1. Level of significance was accepted at 𝑃 < 0.05. |
After correction for the confounding factors screened from the univariate analysis, the multivariable linear regression analysis revealed that age, gender, types of statins, HDL-C(STDEV), LDL-C(STDEV), CRP(MEAN) and creatinine were risk factors for NLR variability. Baseline TC and baseline HDL-C were protective factors for the variability in NLR (see Table 3).
For HDL-C(STDEV), multivariate linear regression analysis results for each subgroup are stable, suggesting that HDL-C(STDEV) is a risk factor for NLR variability during the follow-up (see Fig. 3).
On the other hand, the relationship between LDL-C(STDEV) and NLR variability was consistent across the patients with controlled blood lipid ([ꞵ] 0.699, [95% CI] 0.252–1.145, p-value = 0.002), diabetes ([ꞵ] 0.839, [95% CI] 0.151–1.528, p-value = 0.017), those with no diabetes ([ꞵ] 0.602, [95% CI] 0.181–1.024, p-value = 0.005), those taking statins ([ꞵ] 0.929, [95% CI] 0.524–1.315, p-value < 0.001), atorvastatin ([ꞵ] 0.777, [95% CI] 0.318–1.236, p-value = 0.001) or rosuvastatin ([ꞵ] 0.553, [95% CI] 0.003–1.072, p-value = 0.037) (see Fig. 4).