Clinical significance of the monocyte to high-density lipoprotein cholesterol ratio in the assessment of imperfect ST-segment resolution in elderly patients with acute ST-elevation myocardial infarction after percutaneous coronary intervention / 中华老年医学杂志

ABSTRACT

Objective To investigate the clinical significance of the monocyte count/high-density lipoprotein cholesterol ratio(MHR)in evaluating imperfect ST-segment resolution in elderly patients with acute ST-elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods This was a retrospective cohort study.A total of 274 elderly patients with STEMI underwent PCI in our hospital from December 2015 to December 2018 were enrolled.Based on the extent of the ST-segment resolution of the postoperative electrocardiogram,patients were divided into an imperfect ST-segment resolution group (observation group,n =79)and a favorable ST-segment resolution group (control group,n =195).General clinical data were compared between the two groups,and logistic regression equation was used to analyze the association of MHR with ST-segment resolution.Receiver operating characteristic(ROC)curve was performed to assess the predictive value of MHR for imperfect ST-segment resolution.Results Compared with patients in the control group,patients in the observation group were associated with a significantly higher proportion of anterior wall myocardial infarction and heart failure (≥ Killip 2),A longer duration of chest pain to balloon expansion,higher levels of creatine kinase isoenzyme,N-terminal pro-brain natriuretic peptide,hypersensitive C-reactive protein,blood sugar,blood uric acid,fibrinogen,triglyceride and mononuclear cell count,and lower levels of high density lipoprotein cholesterol and lymphocyte count (all P＜0.05).Meanwhile,there was a significant difference in MHR between the observation group and the control group [(0.75 ± 0.22) vs.(0.48 ± 0.19),t =9.831,P =0.001].Multivariate Logistic regression analysis showed that MHR was an independent risk factor for imperfect ST-segment resolution(OR =1.950,95％Cl1.646-5.430,P =0.003)and ROC curve showed the threshold value of MHR at 0.67,the area under the curve at 0.867,the sensitivity at 79.72％,and the specificity at 79.61％.Conclusions MHR may be an independent risk factor and a good predictive index for imperfect ST-segment resolution in elderly patients with STEMI after PCI.