Association of Neutrophil-To-Lymphocyte Ratio and Atherogenic Index of Plasma With Angiographically Confirmed Coronary Artery Disease.

Abstract

BackgroundThe neutrophil-to-lymphocyte ratio (NLR) and atherogenic index of plasma (AIP) have been associated with coronary artery disease (CAD). We investigated their associations with angiographically confirmed CAD and lesion severity.MethodsThis retrospective study included 2,933 patients undergoing coronary angiography for suspected CAD at Wuhan Third Hospital. CAD was defined as ≥50% luminal stenosis in at least one major coronary artery or branch. Lesion severity was assessed using the Gensini score. Multivariable logistic regression and receiver operating characteristic analyses were performed.ResultsAmong 2,933 patients, 1,615 had CAD and 1,318 had no significant stenosis. NLR and AIP were higher in patients with CAD and increased across Gensini score categories (all P<0.05). After adjustment, AIP remained independently associated with CAD (OR=1.557, P=0.042), whereas NLR did not (OR=1.019, P=0.581). AIP alone showed limited discrimination (AUC=0.537). A multivariable model including age, blood pressure, fasting blood glucose, and AIP showed an AUC of 0.779. Adding AIP did not significantly improve AUC (DeLong P=0.153) or NRI (0.071, P=0.106), although IDI improvement was significant (0.002, P<0.05).ConclusionsIn patients undergoing coronary angiography for suspected CAD, NLR and AIP were associated with CAD and angiographic disease burden. AIP remained independently associated with CAD, whereas NLR did not. However, AIP showed limited discrimination and no clear incremental improvement beyond conventional variables. These findings do not support population screening or routine clinical implementation.