ABSTRACT
In clinical practice, we need to develop new tools to identify the residual cardiovascular risk after acute coronary syndrome (ACS). This study aimed to evaluate whether the monocyte to high-density lipoprotein cholesterol ratio (MHR) variation (ΔMHR) obtained during hospital admission (MHR1) and repeated in the first outpatient evaluation (MHR2) is a predictor of major adverse cardiovascular events (MACE) after ACS. One hundred ninety-one patients admitted for ACS were prospectively included. The ΔMHR was calculated by subtracting MHR1 from MHR2. Patients were followed for 166±38 days in which the occurrence of MACE was observed. The best cutoff for ΔMHR was zero (0), and individuals were divided into two groups: ΔMHR<0 (n=113) and ΔMHR≥0 (n=78). The presence of MACE was higher in the ΔMHR≥0 (22%) than in the ΔMHR<0 (7%), with a hazard ratio (HR) of 3.96 (95% confidence interval [CI]: 1.74-8.99; P=0.0004). After adjusting for confounders, ΔMHR≥0 remained an independent MACE predictor with an adjusted HR of 3.13 (95%CI: 1.35-7.26, P=0.008). In conclusion, our study showed that ΔMHR was an independent MACE predictor after ACS. Thus, ΔMHR is a potential marker of residual cardiovascular risk after ACS.
ABSTRACT
Objective:To investigate the relationship between monocyte to high-density lipoprotein cholesterol ratio(MHR)and the thrombolysis in myocardial infarction(TIMI)risk score in elderly patients with ST elevation myocardial infarction(STEMI).Methods:This was a prospective clinical trial.A total of 152 patients admitted to Tangshan Workers' Hospital were enrolled between January 2015 to February 2018.Of these, 102 STEMI patients undergone primary percutaneous coronary intervention(PCI)were selected as the STEMI group and 50 patients with angiographically normal coronary arteries were selected as the control group.The STEMI patients were divided into two subgroups based on TIMI risk scores.The relationship between MHR and TIMI risk scores in patients with STEMI was analyzed.Logistic regression was used to analyze whether MHR could be used as an independent predictor of acute STEMI and high TIMI scores.Results:The MHR level was significantly higher in the STEMI group than in the control group( P<0.05)and was significantly higher in the high TIMI score subgroup than in the low TIMI score subgroup( P<0.05). In multivariate Logistic regression analysis, MHR was an independent predictor of high TIMI scores in acute STEMI(P<0.05). In correlation analysis, there was a significant positive correlation between MHR and TIMI score in STEMI patients( r=0.396, P<0.01). The ROC curve showed that the area under the curve of MHR was 0.815(95% CI: 0.734-0.896, Z=7.613, P<0.01). When the MHR optimal cut-off value was 2.380, the sensitivity was 55.22% and the specificity was 97.14%. Conclusions:MHR is significantly associated with the TIMI score in patients with STEMI.MHR may be used as a supplementary parameter for assessing the prognosis of STEMI patients.
ABSTRACT
Objective To investigate the prediction by intravascular ultrasound (IVUS) with monocyte to high density lipoprotein-cholesterol (HDL-C) ratio (MHR) of 12-month prognosis in patients with intermediate non-left main coronary lesions after percutaneous coronary intervention (PCI). Methods Patients with intermediate non-left main coronary lesions diagnosed by coronary angiography were tested of monocyte counts and HDL-C levels at admission with MHRs calculated. IVUS was used to examine plaque stability in target lesions. Patients were dviided into stable plaque group (n=44) and unstable plaque group (n=140) according to the IVUS results. PCI was then operated in patients with unstable plaque or with minimum lumen area<4 mm2. The major adverse cardiovascular events (MACE) were recorded during the follow-up period of 12 months after PCI. Results MHR was significantly higher in unstable plaque group than that in stable plaque group[(22.6±8.4) vs.(14.1±7.2),P<0.001]. Receiver-operating characteristic (ROC) analysis revealed that an MHR cut-off of 16.05 had 74.2％ sensitivity and 77.0％ specificity for prediction of 12-month MACE after PCI (AUC 0.78, 95％ CI 0.71–0.85, P<0.001). Besides, unstable plaque with MHR over 16.05 was an independent risk factor for 12-month MACE after PCI (adjusted HR 3.26, 95％ CI 2.48–4.14, P=0.020). Conclusions IVUS combined with MHR is a valuable index predicting the prognosiso f patients with intermediate non-left main coronary lesions who underwent PCI.