Inflammatory biomarkers as predictors of calcific aortic stenosis severity: examining platelet to lymphocyte and neutrophil to lymphocyte ratios

Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are novel inflammatory markers known for inflammatory and cardiovascular diseases. This study aimed to examine PLR and NLR as predictors of calcification aortic stenosis (CAS) severity.  This study investigated a total of 155 individuals who were referred to Chamran Heart Center in Esfahan, Iran between 2018 and 2019. The participants included 53 patients with severe AS, 50 patients with mild to moderate AS, and 52 individuals as a control group. The severity of aortic stenosis was evaluated in all participants using echocardiography. The study also calculated the PLR and NLR from CBC.  The results of this study indicate that there was no significant difference in PLR among those with severe AS (108±66), mild to moderate AS (103±43), and the control group (110±50) (p=0.813). However, the NLR was significantly higher in those with severe AS (3.13±2.3) compared to mild to moderate AS (2.08±0.7) and the control group (2.1±1.3) (p=0.019). Age and diabetes mellitus were found to be significant and independent factors correlated with PLR, while the severity of AS was not. Additionally, severe AS was found to be an independent predictor of NLR, along with age and sex.  This study elucidated the intricate relationship between inflammatory markers and CAS, emphasizing the significance of NLR as an indicator of pro-inflammatory and anti-inflammatory contrast. Surprisingly, PLR exhibited no relationship with CAS severity. we suggest that future studies examine the effect of ethnic variation on the relationship between inflammatory markers and CAS. Also, explore the potential impact of additional inflammatory markers on new indices that may provide stronger predictive value for CAS severity.