We prospectively examined 2370 consecutive patients with chronic CAD, as shown by a >50 % coronary stenosis (in 95 % of patients), previous coronary revascularization (in 31 % of patients), and/or previous myocardial infarction (MI, in 54 % of patients). We tested the ability of laboratory and clinical variables to predict future cardiac events (cardiac death and non-fatal MI).
During follow-up (median, 46 months), 147 patients (6.2 % ) died from cardiac causes and 81 (3.4 % ) experienced a non-fatal MI. Using multivariate analysis, after adjustment for clinical variables (including left ventricular ejection fraction and angiographic extent of coronary stenoses), a high-density lipoprotein cholesterol (HDLc) concentration < 35 mg/dL (p < 0.0001), a neutrophil-to-lymphocyte ratio >2.4 (p = 0.0014), and an fT3 serum level < 2.1 pg/mL with normal thyrotropin (low-T3 syndrome) (p = 0.0260) showed an independent and incremental prognostic value, and were associated with an increase in the rate of cardiac events of 86 % , 57 % and 41 % , respectively. When these variables were added to clinical and instrumental variables, the prognostic power of the model increased significantly (global chi-square improvement: from 157.01 to 185.07, p < 0.0001).
Low HDLc, high neutrophil-to-lymphocyte ratio and low-T3 syndrome, both individually and taken together, provide prognostic information that is independent of and incremental to the main clinical and instrumental findings.