Feliciano Chanana Paquissi
2016
Abstract
Peripheral arterial disease (PAD) is an important manifestation of atherosclerosis, with increasing prevalence worldwide. A growing body of evidence shows that the systemic inflammatory response is closely related to the development, progression, and prognosis of atherosclerosis. In the last decade, several studies have suggested the role of measured inflammatory biomarkers as predictors of severity and prognosis in PAD in an effort to stratify the risk of these patients, to improve treatment selection, and to predict the results after interventions. A simple inflammatory marker, more available than any other, is the neutrophil–lymphocyte ratio (NLR), which can be easily obtained in clinical practice, based on the absolute count of neutrophils and lymphocytes from the differential leukocytes count. Many researchers evaluated vigorously the NLR as a potential prognostic biomarker predicting pathological and survival outcomes in patients with atherosclerosis. In this work, we aim to present the role of NLR as a prognostic marker in patients with PAD through a thorough review of the literature.
Conclusion and future directions
From the available evidence, it is very likely that the presence of a high NLR has predictive value for future vascular events in asymptomatic and symptomatic subjects. This simple, fast, and widely available biomarker can offer an additional noninvasive tool for risk stratification to assess the severity, response to treatment and prognosis of PAD.
More studies are necessary to know and clarify the role of NLR as an additional tool in PAD. This is reinforced because its role has been reproducible and consistent in other vascular beds as cerebral and coronary, especially in the current scenario of growing recognition of various diseases, with chronic inflammatory component as risk factors for atherosclerosis.
Further studies should be addressed to establish the normality value for specific populations to clarify the underlying mechanisms in atherogenesis and should be designed to assess the effectiveness of anti-inflammatory therapies using the fall of NLR as a surrogate outcome and assess its role to guide therapy.
