Effect of ratio of monocyte to high-density lipoprotein cholesterol on prognosis of patients with non-ST-segment elevation acute coronary syndrome

Abstract

Objective To investigate the effect of monocyte-to-high density lipoprotein cholesterol ratio (MHR) on the cardiovascular outcomes in the patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods This was a retrospective cohort study involving 435 patients diagnosed with NSTE-ACS (males accounted for 67.4% and median age 62 years) who were admitted between January 2017 and September 2017 in our hospital. According to the tertile of MHR, the subjects were divided into the low MHR group (0.152~0.433, n=145), the medium MHR group (0.435~0.633, n=145), and the high MHR group (0.636~2.904, n=145). Clinical data were compared among the 3 groups, the correlation between MHR and cardiovascular risk factors was evaluated, and the association of MHR with major adverse cardiovascular and cerebrovascular events (MACCE) was assessed during 12-month follow-up after admission. Results MHR was positively correlated with C-reactive protein (CRP, r=0.534, P < 0.01) and Global Registry of Acute Coronary Event scores (GRACE, r=0.433, P < 0.01) in the NSTE-ACS population. During the 12-month follow-up period, totally 78 patients with NSTE-ACS developed MACCE (17.9%), and their MHR levels were higher than those without MACCE (P < 0.01). There were 35, 25 and 16 cases respectively developing MACCE in the high, medium and low MHR groups, and significant difference was seen among the 3 groups (P=0.006). Kaplan-Meier analysis revealed that the high MHR group had the higher incidence rate of MACCE than the other groups (log-rank=9.786, P=0.007). COX regression analysis showed that MHR was associated with MACCE (HR=2.528, 95%CI: 1.500~4.261, P < 0.01). Multivariate analysis further indicated that MHR was an independent predictor of MACCE after adjustment (adjusted HR=2.193, 95%CI: 1.075~4.472, P=0.031). Conclusion MHR is associated with MACCE and is an independent predictor of cardiovascular outcomes in NSTE-ACS patients.

Keywords

• inflammation
• monocyte-to-high density lipoprotein cholesterol ratio
• non-st-segment elevation acute coronary syndrome
• cardiovascular events