We would like to thank Mustafa Gülgün for his interest in our manuscript. We investigated calcific aortic stenosis and its correlation with a novel inflammatory marker, the lymphocyte/monocyte ratio (LMR). We found a statistically significant difference in terms of LMR in patients compared with healthy controls and also found an inverse relationship between severity of calcific aortic stenosis and LMR.1 Mustafa Gülgün pointed out that the lymphocyte cell count is affected by various clinical factors such as gender, age, race, time of sampling, physical and psychological stress, pregnancy, drugs, infections, smoking, presence of anti-lymphocyte autoantibodies and procedures such as splenectomy. As we stated in our paper, we excluded patients that had active or chronic infection, systemic inflammatory or allergic disease, and renal, hepatic or hematologic disease. Besides, there were there no significant differences between the groups in terms of age, gender, smoking status or type of drugs used by the participants. All of our patients were Caucasian. In our hospital blood samples are drawn before midday after 10 hours of fasting, and we only used fasting blood samples for study. In addition, all the study participants were aged over 60, and at their age they were unlikely to perform heavy exercise.

In short, we tried to minimize the factors that could affect lymphocyte counts and other blood parameters. On the other hand, we agree with the author that prospective research into this topic may be useful.