Monocyte to high-density lipoprotein ratio (MHR) as a predictor of mortality and major adverse cardiovascular events (Mace) among ST elevation myocardial infarction (Stemi) patients undergoing primary percutaneous coronary intervention: A meta-analysis (original) (raw)
Related papers
Future Cardiology
Aim: This study examined the relationship between Thrombolysis in Myocardial Infarction (TIMI) score and monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR) with Global Registry of Acute Coronary Events (GRACE) in patients with acute coronary syndrome (ACS). Materials & methods: A total of 1000 patients with ACS admitted to the Cardiology Department of the Dustira Army Hospital were included in this study. Medical records were retrospectively reviewed from January 2019 to June 2020 with consecutive sampling. Results: In the group with a higher TIMI score, the MHR result was considerably higher. In the same way, MHR was more significant in the group with a high-risk than in low-risk GRACE. Conclusion: MHR is a convenient, reproducible and correlates with GRACE and TIMI score as predictive biomarkers in patients with ACS.
Arquivos Brasileiros de Cardiologia, 2018
Background: Assessing the monocyte to high-density lipoprotein ratio (MHR) is a new tool for predicting inflamation, which plays a major role in atherosclerosis. Myocardial bridge (MB) is thought to be a benign condition with development of atherosclerosis, particularly at the proximal segment of the brigde. Objective: To evaluate the relationhip between MHR and the presence of MB. Methods: We consecutively scanned patients referred for coronary angiography between January 2013-December 2016, and a total of 160 patients who had a MB and normal coronary artery were enrolled in the study. The patients' angiographic, demographic and clinic characteristics of the patients were reviewed from medical records. Monocytes and HDL-cholesterols were measured via complete blood count. MHR was calculated as the ratio of the absolute monocyte count to the HDL-cholesterol value. MHR values were divided into three tertiles as follows: lower (8.25 ± 1.61), moderate (13.11 ± 1.46), and higher (21.21 ± 4.30) tertile. A p-value of < 0.05 was considered significant. Results: MHR was significantly higher in the MB group compared to the control group with normal coronary arteries. We found the frequency of MB (p = 0.002) to increase as the MHR tertiles rose. The Monocyte-HDL ratio with a cut-point of 13.35 had 59% sensitivity and 65.0% specificity (ROC area under curve: 0.687, 95% CI: 0.606-0.769, p < 0.001) in accurately predicting a MB diagnosis. In the multivariate analysis, MHR (p = 0.013) was found to be a significant independent predictor of the presence of MB, after adjusting for other risk factors. Conclusion: The present study revealed a significant correlation between MHR and MB.
Heart, lung & circulation, 2016
We aimed to investigate the usefulness of monocyte to HDL cholesterol ratio (MHR) in predicting coronary artery disease severity and future major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS). 2661 patient with ACS were enrolled and followed up during median 31.6 months. MHR were significantly positively correlated with neutrophil to lymphocyte ratio (r=0.438), CRP (r=0.394), Gensini (r=0.407), and SYNTAX score (r=0.333). During in-hospital and long-term follow-up, MACE, stent thrombosis, non-fatal MI, and mortality occurred more frequently in the third tertile group. Kaplan-Meier analysis revealed the higher occurrence of MACE in the third tertile group compared with other tertiles. Adjusting for other factors, a MHR value in the third tertile group was determined as an independent predictor of in-hospital and long-term MACE. MHR as a novel inflammation-based marker seemed to be an independent predictor of severity of coronary artery disease an...
International Journal of the Cardiovascular Academy, 2017
PURPOSE:Monocyte-high density lipoprotein ratio (MHR) has recently emerged as a marker of inflammation and oxidative stress in the cardiovascular disease.We aimed to investigate whether baseline MHR is associated with functional significance of intermediate coronary artery lesions. METHODS:Three hundred and one consecutive patients, 215 males and 86 females, who underwent fractional flow reserve (FFR) measurement for angiographically intermediate coronary stenosis (40-70% in quantitative coronary analysis) in the left anterior descending coronary artery were enrolled into the study. An FFR value of ≤0.80 was accepted for hemodynamic significance. RESULTS: Of the 301 patients, 115 (38.2%) exhibited significant functional stenosis (FFR≤0.80) in the FFR measurement. Patients with hemodynamically significant lesions had higher MHR values (11.6±3.3 vs. 12.6±2.5 p=0.003).In stepwise multivariate logistic regression analysis, total cholesterol (OR = 1.008, 95% CI = 1.002-1.013, p < 0.010), plateletcrit (OR = 1.310, 95% CI = 1.097-1.564, p = 0.013) and MHR (OR=2.993,95% CI =1.365-6.561,p=0.008) were independent predictors of significant functional stenosis.An MHR value of 12.1 had 65% sensitivity and 55 % specificity for prediction of hemodynamically significant coronary artery stenosis. CONCLUSIONS:Increased MHR values were associated with functional significance of angiographically intermediate coronary artery stenosis.
Dicle Medical Journal, 2022
Objective: Monocyte to high-density lipoprotein ratio (MHR) is a biomarker of inflammatory response. In this study, we investigated the relationship between MHR and mortality in patients with chronic coronary artery occlusion (CTO). Method: Retrospective observational study including 493 patients over a follow up period of 73 months. Blood samples were taken before cardiac catheterization for coronary angiography. Results: Median follow-up was 48 months(26-73). Patients were seperated into two groups: (I) MHR <17.68 (n=278, 95 females) and (II) MHR ≥17.68 (n=215, 45 females). Mortality was considerably higher in MHR II than in MHR I (n=70 vs. n=43; p<0,001). MHR was an independent predictor of mortality (OR: 1.089, 95% [CI]: 1.055-1.124, p<0,001). Lower survival rates were found in MHR II on Kaplan-Meier analyses when compared to that of MHR I (75.223±2.670 vs. 89.220±2.102, p<0,001). Conclusions: As a simple, easy applicable and universal marker, MHR may be a parameter that predicts mortality risk and survival time in CTO patients.
Kosuyolu Heart Journal
Introduction: Circulating monocyte count is predictive of new atherosclerotic plaque development. In addition, there is a strong inverse relationship between high-density lipoprotein (HDL) cholesterol and atherosclerosis. We aimed to investigate the relationship between the monocyte/HDL cholesterol ratio and severity of coronary artery disease. Patients and Methods: A total of 760 patients who underwent coronary angiography were included in the study. The severity of coronary atherosclerosis was calculated by the Gensini score, and the patients were grouped as having low (< 20) and high (> 20) Gensini scores. Baseline characteristics and laboratory parameters were recorded and compared between patients with low and high Gensini scores. Results: Hypertension, diabetes mellitus, hyperlipidaemia, advanced age and smoking were more common in patients with a high Gensini score. Fasting blood glucose levels, creatinine levels and monocyte/HDL cholesterol ratio were significantly lower in patients with a low Gensini score than in those with a high Gensini score. Logistic regression analysis revealed that older age, fasting blood glucose levels, hyperlipidaemia, family history of coronary artery disease and male gender were independent predictors of a high Gensini score. We observed a correlation between the monocyte/HDL cholesterol ratio and Gensini score (p< 0.001). However, this correlation was weak (Spearman's rho = 0.159). Conclusion: We observed a positive but weak correlation between the monocyte/HDL cholesterol; ratio and increased coronary atherosclerotic burden, as calculated by Gensini scoring. Further studies are required to demonstrate the relationship between the monocyte/HDL cholesterol ratio and atherosclerotic cardiovascular disease.
The Egyptian Journal of Hospital Medicine
Background: Coronary artery tortuosity (CorT) is a prevalent angiographic finding commonly associated with aging, hypertension, atherosclerosis and other cardiovascular conditions. It has been suggested that coronary artery tortuosity causes alteration in blood flow and reduction in coronary artery pressure distal to the tortuous segment and can thus lead to ischemia. Objective: This study aimed to find the relationship between monocytes to high density lipoprotein cholesterol ratio (MHR) and isolated coronary artery tortuosity (CorT) without obstructive coronary artery disease (CAD). Patients and Methods: This study is an observational retrospective case control study that was performed in National Heart Institute and Zagazig University Hospital between January 2018 and January 2020 for patients with stable coronary artery disease that underwent coronary angiography. In this study 60 patients with chronic stable angina were enrolled, 30 patients showed Cor-T without obstructive CAD (cases) on coronary angiography, while the other 30 patients showed normal coronaries (Control). Results: The most two predictable factors for the detection of Cor-T are MHR and C-reactive protein (CRP). In Cor-T group there was a significant positive correlation between the number of tortuous vessels and the MHR with P-value <0.001, the more number of tortuous vessels the higher MHR. Conclusions: The relationships between the noninvasive laboratory index MHR and coronary artery tortuosity is significant. These findings consider MHR as an accurate, quantitative, non-invasive, highly available and non-expensive parameter for the prediction and detection of Cor-T and may be useful for risk stratification.
Coronary Artery Disease, 2015
The aim of this study was to investigate the relationship between lymphocyte to monocyte ratio (LMR) and the severity of coronary artery disease (CAD) by using Gensini score. A total of 199 patients, who had undergone coronary angiography, were included in the study and retrospectively analyzed. Among them, 49 patients who had normal coronary arteries were selected as the control group. Patients with CAD were divided into 2 groups, those with low Gensini score (40) and those with high Gensini score (≥40). Our results showed that LMR in the severe atherosclerosis group was significantly lower than those of the mild atherosclerosis group and the control group. There was a closely significant correlation between the Gensini score and LMR (r = À0.362, P < .001). Furthermore, multivariate logistic regression analysis demonstrated that LMR (odds ratio, 0.715; 95% confidence interval [CI], 0.551-0.927; P = .012) was independent predictors of severe atherosclerosis. Using an optimal LMR cutoff value of 5.06, LMR predicted severe atherosclerosis with a sensitivity of 57.1% and specificity of 69.7% (area under curve = 0.634; 95% CI, 0.545-0.724; P = .005). Then patients with CAD group was divided into 2 groups according to the LMR value of 5.06. Patients with LMR 5.06 had worse prognosis, with a higher rate of cardiovascular events during up to 1 year follow-up. Our study demonstrated that LMR was independently and positively associated with the severity of coronary atherosclerosis, providing a new insight in the application of inflammation index evaluating the severity of CAD. And LMR may be a useful predictor of future cardiovascular events in patients with CAD. Abbreviations: ACEI = angiotensin-converting enzyme inhibitor, ARB = angiotensin II receptor blocker, CAD = coronary artery disease, CI = confidence interval, Cr = creatinine, GLU = glucose, HDL-C = high-density lipoprotein cholesterol, LDL-C = lowdensity lipoprotein cholesterol, LMR = lymphocyte to monocyte ratio, LVEF = left ventricular ejection fraction, NLR = neutrophil to lymphocyte ratio, OR = odds ratio, RR = relative risk, TC = total cholesterol, TG = triglyceride, WBC = white blood cell.