# Correlation of neutrophil/lymphocyte, monocyte/lymphocyte, and CRP/ALB ratios with the extent of coronary artery lesions and their predictive value

## TL;DR

This study shows that blood cell ratios and a protein marker can predict the severity of heart artery disease and help diagnose it more accurately.

## Contribution

The study demonstrates that combining NLR, MLR, and CRP/ALB ratios improves CHD diagnosis accuracy compared to using single indicators.

## Key findings

- NLR, MLR, and CRP/ALB levels are significantly higher in CHD patients than in controls.
- Combined use of NLR, MLR, and CRP/ALB achieves high diagnostic accuracy (AUC 0.931) for CHD.
- These ratios are independent risk factors for CHD and correlate with disease severity.

## Abstract

The aim of this paper was to investigate the correlation between neutrophil/lymphocyte (NLR), monocyte/lymphocyte (MLR), and CRP/ALB ratios with the degree of coronary artery disease and their predictive value.

This study retrospectively analyzed 510 patients with clinically proposed coronary artery disease who underwent coronary angiography between January 2022 to December 2024, 256 in the group with a definite diagnosis of coronary artery disease after examination, and 254 in the control group. Baseline data of all study subjects were collected and organized, and NLR, MLR, and CRP/ALB levels were compared in the control group and CHD patients. Coronary stenosis severity was scored by Gensini score. Pearson or Spearman correlation coefficients were used to analyze the correlation between NLR, MLR, and CRP/ALB levels and the Gensini score, respectively, in CHD patients. Factors influencing the occurrence of CHD were analyzed by logistic regression. The diagnostic value of NLR, MLR, and CRP/ALB in CHD patients was analyzed by ROC curve.

The levels of NLR, MLR, and CRP/ALB were significantly higher in CHD patients than in the control group (all P < 0.001). There was a significant positive correlation between NLR (r = 0.546), MLR (r = 0.445), and CRP/ALB (r = 0.500) and the Gensini scores in CHD patients. Further analysis revealed that gender (male), hypertension, diabetes mellitus, hyperlipidemia, family history, DBP, TG, FBG, UA, NLR, MLR, and CRP/ALB were independent risk factors for the development of CHD, whereas HDL-C demonstrated an independent protective effect against CHD. The area under the curve (AUC) was significantly higher in the case of the combined diagnosis of CHD with NLR, MLR, and CRP/ALB (AUC reached 0.931, with a sensitivity of 86.33% and a specificity of 83.86%), which was significantly better than that of single-indicator diagnosis (all P < 0.001).

The levels of NLR, MLR, and CRP/ALB in CHD patients were all significantly and positively correlated with the degree of coronary artery disease; moreover, the levels of NLR, MLR, and CRP/ALB have high diagnostic and predictive value for CHD patients.