Positive Association between Neutrophil-Lymphocyte Ratio and Presence of Panoramically Imaged Carotid Atheromas Among Men

Publication date: Available online 11 October 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Arthur H. Friedlander, Urie K. Lee, John C. Polanco, Hoang-Anh Tran, Tina I. Chang, Robert S. Redman

Abstract

Objective

Heightened levels of systemic inflammation documented by elevated neutrophil-lymphocyte ratios (NLRs) characterize robust atherosclerosis processes evidenced by carotid and coronary artery plaques on ultrasound and angiography with associated strokes and myocardial infarctions (MIs). Therefore, we sought to determine if calcified carotid artery plaques (CCAP) on panoramic images (PIs), known to herald future stroke and MI, are associated with elevated NLRs.

Study Design

Utilizing a cross-sectional study design, we reviewed electronic medical records and PIs of non-Hispanic White males ≥55 years, treated by Dental Service (January 1, 2017 – December 31, 2017). Two groups of patients (N = 50 each) with plaque (CCAP+) and without plaque (CCAP–) were constituted. The predictor variable was CCAP+ and outcome variable was the NLR. A t-test analyzed the differences in mean NLRs between groups. Other variables of interest, that is atherogenic risk factors (hypertension, hyperlipidemia, and diabetes mellitus) were included in a logistic regression analysis to assess their influencing the association of CCAP with NLR. Significance set at 0.05 for all tests.

Results

The study group of 50 CCAP+ males (mean age 71.7 ± 7.47) evidenced a mean NLR of 3.07 ± 1.43. The control group of 50 CCAP– males (mean age 69.8 ± 9.29) evidenced a mean NLR of 2.13 ± 0.68. T-test analysis comparison demonstrated a significant (P = 0.00007) difference (95% CI: 0.49-1.39). Logistic regression failed to show any significant relationship of NLR with the covariate/other variables of interest.

Conclusion

There is a strong association between the presence of CCAP seen on PIs of older non-Hispanic White males and extent of systemic inflammation as evidenced by elevated NLRs. These plaques are "risk factors/indicators" for future stroke and MI. Therefore, maxillofacial surgeons providing care for patients having CCAP on their PI, should consider referring them for a comprehensive cerebrovascular and cardiovascular workup.

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