Association of Neutrophil/Lymphocyte Ratio with Plaque Morphology in Patients with Asymptomatic Intermediate Carotid Artery Stenosis

BACKGROUND AND OBJECTIVES: Non-calcified carotid plaques are more unstable than calcified plaques, and they are associated with a higher risk of rupture, thromboembolism, and consequently, stroke. The purpose of the present study is to compare calcified and non-calcified plaques that cause intermediate carotid artery stenosis with respect to neutrophil/lymphocyte ratio (NLR). SUBJECTS AND METHODS: A total number of 139 asymptomatic patients with 50-70% stenosis of the carotid artery were included in this study. Carotid Doppler ultrasound imaging and computed tomography angiography were performed to divide the carotid artery plaques into two groups as calcified and non-calcified. Patients included in the calcified (n=73) and non-calcified (n=66) plaque groups were compared with respect to total neutrophil count, lymphocyte count and NLR. RESULTS: Total lymphocyte count was statistically significantly lower in the non-calcified plaque group compared to the calcified plaque group (total lymphocyte count in non-calcified/calcified plaque groups [103/mm3]: 2.1/2.3, respectively) (p=0.002). NLR was statistically significantly higher in the non-calcified plaque group compared to the calcified plaque group (NLR in non-calcified/calcified plaque groups: 2.6/2.1, respectively) (p2.54. Multivariate regression analysis showed that NLR was independently associated with non-calcified carotid artery plaques (odds ratio 5.686, 95% CI 2.498-12.944, p<0.001). CONCLUSIONS: NLR is increased in the presence of non-calcified carotid artery plaques that cause asymptomatic intermediate stenosis. Increased NLR can be used as a marker to assess the risk of rupture of non-calcified carotid artery plaques.

Comparison of DTPA and MAG3 renal scintigraphies in terms of differential renal function based on DMSA renal scintigraphy

Renal scintigraphy has privileges in imaging methods in terms of providing functional information. Technetium-99m dimercaptosuccinic acid [Tc-99m DMSA] used in imaging of renal parenchyma is the most reliable radiopharmaceutical in the calculation of differential renal function [DRF]. In this study, it was aimed to compare the agents of dynamic renal scintigraphy such as Technetium-99m diethylenetriamine pentaacetic acid [Tc-99m DTPA] and Technetium-99m mercaptoacethyltriglycine [Tc-99m MAG3] based on Tc-99m DMSA in terms of DRF. Tc-99m DTPA and Tc-99m DMSA scintigraphies were performed in Group A; Tc-99m MAG3 and Tc-99m DMSA scintigraphies were performed in Group B. There were 57 patients [23 F, 34 M; mean age: 18.8 +/- 17.1 years old [range: 3 months-60 years]] in Group A and 30 patients [15 F, 15 M; mean age: 15.7 +/- 14.8 years old [range: 3 months-59 years]] in Group B. The DRF values calculated with Tc-99m DTPA and Tc-99m MAG3 were statistically compared with Tc-99m DMSA. Both Tc-99m DTPA and Tc-99m MAG3 were found quite concordant with Tc-99m DMSA in terms of DRF [p= 0.968, R2= 0.94 and p= 0.989, R2= 0.98, respectively]. Despite the fact that DMSA is accepted as the most reliable radiopharmaceutical in the determination of DRF, the reliable results are also obtained in dynamic renal scintigraphy which was carried out with DTPA or MAG3. In addition, the functional status of the kidney could be determined with these techniques. MAG3 scintigraphy may be mainly preferred because of giving better information than DTPA about both the function of the kidneys and the structure of the renal parenchyma.