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Abstract NSTE-ACS is one of the leading causes of death in patients with CAD. Patients with NSTE-ACS tend to have multi-vessel CAD and similar cardiovascular mortality compared to patients with STE-ACS. Several treatment strategies including intensive medical treatment and invasive procedures have been successful in decreasing the morbidity and mortality of NSTE-ACS. However, the severity of CAD in coronary angiography is the leading factor in determining the most useful treatment strategy. The role of inflammation in the initiation and progression of coronary atherosclerosis is well described. Increased levels of inflammatory markers have been found in association with the severity of coronary atherosclerosis and prognosis in acute coronary syndromes. The NLR is an indicator of baseline inflammatory response. Syntax score was developed as part of the Syntax trial with the object to characterize and objectively quantify the severity and extent of CAD (Geng, et al, 2007). Subsequent assessments of the Syntax both within the Syntax trial and in external datasets have demonstrated the score’s ability to predict adverse ischemic events in patients undergoing percutaneous coronary intervention (PCI). Moreover, the integration of clinical variables in the Syntax has provided a significant improvement in the process of risk stratification. We investigated whether there was an association between the NLR and severity of CAD in patients with NSTE-ACS using the Syntax score. This study included 100 consecutive patients who presented with NSTE-ACS and had coronary angiography. There were 77 males (77%) with the mean age was 46.53 ± 7.43 There was statistically significant positive correlation between Syntax score and Age, Cholesterol, LDL, Creatinine, CK, CK-MB, NLR and Hs-cTnI (ng/ml), and there was statistically significant positive correlation between Syntax score and HDL, and there was no statistically significant positive correlation between Syntax score and BMI, Triglycerides, Urea and TLC. There was statistically significant positive correlation between NLR and Age, Cholesterol, LDL, Urea, Creatinine, CK, CK-MB, TLC, Syntax score and Hs-cTnI (ng/ml), and there was no statistically significant positive correlation between NLR and BMI, HDL and Triglycerides ROC curves were plotted to detect the cut-off point of NLR for detecting high Syntax score. An NLR of > 5.5 had a sensitivity of 100.0%, specificity of 77.4% for detecting high syntax score. To our knowledge, no data about NLR cut-off point for detecting high Syntax score was reported in literature. |