Association of Neutrophil to Lymphocyte Ratio and Pulmonary Hypertension in Sarcoidosis Patients

Authors

1 Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Miami, FL, USA,

2 Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands,

3 Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran,

4 Professor of Surgery/ Anesthesiology, Professor of Molecular Pharmacology and Physiology, University of South Florida, FGTBA and TEAM Health, Tampa, Florida, USA.,

5 Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, IL, USA

Abstract

Background: The neutrophil-to-lymphocyte ratio (NLR) has emerged as a new marker of inflammation associated with the severity of several respiratory and cardiac diseases. Materials and Methods: We investigated whether the degree of systemic inflammation in sarcoidosis patients as measured by the NLR is associated with pulmonary hypertension (PH). Results: A NLR > 3.5 occurred with a significantly higher frequency in sarcoidosis patients with PH (50% vs. 24%, P=0.016) yielding a sensitivity of 50%, specificity of 78%, positive predictive value (PPV) of 41.9% and negative predictive value (NPV) of 81.4% and remained independently associated with PH in multivariate analysis (OR: 3.254, 95% CI: 1.094– 9.678, P=0.034). Conclusion: We conclude that level of inflammation in sarcoidosis patients may be associated with the development of PH. Owing to the relatively good specificity and NPV, NLR may be a good negative test, which is a simple, inexpensive and widely available in office-based setting to predict the risk of PH in sarcoidosis patients.

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