{'fraction_non_alphanumeric': 0.026631853785900782, 'fraction_numerical': 0.0, 'mean_word_length': 5.892086330935252, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
White Blood Cell Subtypes and Ratios in Cardiovascular Disease

We read with interest the article by Li et al entitled ‘‘Impact of Neutrophil to Lymphocyte Ratio (NLR) Index and Its Periprocedural Change (NLRDelta) for Percutaneous Coronary Intervention in Patients With Chronic Total Occlusion.’’ The NLR was a potential predictor of chronic total occlusion, and the DNLR was independently associated with adverse outcomes in patients who underwent percutaneous coronary intervention. The white blood cell (WBC) subtypes and ratios are useful inflammatory markers. Several hypotheses have been proposed, including plaque disruption caused by neutrophil infiltration and increased neutrophil–platelet adhesion. Recent studies showed that there is neutrophil invasion of the atherosclerotic plaque. Also, neutrophils can make plaques more vulnerable by enhancing oxidative reactions through the release of proteolytic enzymes, arachidonic acid derivatives, and superoxide radicals. The NLR, an inflammatory marker, is increased in various diseases such as diabetes mellitus, hypertension, metabolic syndrome, obesity, hyperlipidemia, lifestyle habits, and endothelial dysfunction. Several studies reported that a high NLR was independently associated with adverse cardiovascular (CV) outcomes. Recently, several WBC subtypes and ratios were evaluated in patients with CV disease such as the platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and monocyte-to-highdensity lipoprotein cholesterol ratio. These biomarkers are widely available and can easily be calculated from the WBC count. Unlike many other inflammatory markers, they are inexpensive and may provide additional risk stratification beyond conventional risk scores. Although Li et al investigated the value of WBC subtypes, they did not assess the ratios mentioned above. If they had, their study could have been of greater interest. References