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直接经皮冠状动脉介入治疗的ST段抬高型心肌梗死患者单核细胞高密度脂蛋白胆固醇比值与SYNTAX评分及SYNTAX评分Ⅱ的相关性

The Association between Monocyte HDL-C Ratio and SYNTAX Score and SYNTAX Score II in STEMI Patients Treated with Primary PCI.

作者信息

Çağdaş Metin, Karakoyun Süleyman, Yesin Mahmut, Rencüzoğulları İbrahim, Karabağ Yavuz, Uluganyan Mahmut, Ozan Gürsoy Mustafa, Artaç İnanç, İliş Doğan, Atalay Eray, Sadioğlu Çağdaş Öznur

机构信息

Department of Cardiology, Kafkas University Medical Faculty.

Department of Cardiology, Kars Harakani State Hospital, Kars.

出版信息

Acta Cardiol Sin. 2018 Jan;34(1):23-30. doi: 10.6515/ACS.201801_34(1).20170823A.

Abstract

BACKGROUND

Monocyte to high-density-lipoprotein cholesterol ratio (MHR) simply reflects proatherogenic and antiatherogenic balance and high level of this ratio is associated with severity of coronary atherosclerosis and cardiac events. We investigated the association between MHR and coronary artery disease severity using SYNTAX score and SYNTAX score II (SSII) in ST-elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (pPCI).

METHODS

A total of 315 consecutive patients with STEMI who underwent pPCI from January 2014 to January 2016 were enrolled. After exclusion 264 patients remained in the study population. Patients were divided into 2 groups according to median SSII [SSII ≤ 34.2 as low group (n = 132) and > 34.2 as high group (n = 132)].

RESULTS

Median value of MHR was 10.5 in SSII low group and 16.1 in SSII high group (p < 0.001). There was a strong correlation between MHR and SSII (r = 0.580, p < 0.001). Diabetes mellitus [odds ratio (OR): 8.604; 95% confidence interval (CI): 2.469-29.978], glomerular filtration rate (OR: 0.961; 95% CI: 0.939-0.983), infarct related artery of left anterior descending (LAD) (OR: 7.325; 95% CI: 2.262-23.723), SYNTAX score (OR: 1.422; 95% CI: 1.275-1.585), neutrophil to lymphocyte ratio (NLR) (OR: 1.156; 95% CI: 1.058-1.264) and MHR (OR: 1.027; 95% CI: 1.013-1.041) were independent predictors of SSII > 34.2 in multivariate analysis.

CONCLUSIONS

MHR could be a better parameter than NLR and C-reactive protein at predicting severity of coronary artery disease in STEMI patients treated with pPCI.

摘要

背景

单核细胞与高密度脂蛋白胆固醇比值(MHR)简单地反映了促动脉粥样硬化和抗动脉粥样硬化的平衡,该比值升高与冠状动脉粥样硬化的严重程度及心脏事件相关。我们使用SYNTAX评分和SYNTAX评分II(SSII)研究了接受直接经皮冠状动脉介入治疗(pPCI)的ST段抬高型心肌梗死(STEMI)患者中MHR与冠状动脉疾病严重程度之间的关联。

方法

纳入2014年1月至2016年1月期间连续315例行pPCI的STEMI患者。排除后,研究人群中剩余264例患者。根据SSII中位数将患者分为2组[SSII≤34.2为低分组(n = 132),> 34.2为高分组(n = 132)]。

结果

SSII低分组中MHR的中位数为10.5,SSII高分组中为16.1(p < 0.001)。MHR与SSII之间存在强相关性(r = 0.580,p < 0.001)。在多变量分析中,糖尿病[比值比(OR):8.604;95%置信区间(CI):2.469 - 29.978]、肾小球滤过率(OR:0.961;95%CI:0.939 - 0.983)、左前降支(LAD)梗死相关动脉(OR:7.325;95%CI:2.262 - 23.723)、SYNTAX评分(OR:1.422;95%CI:1.275 - 1.585)、中性粒细胞与淋巴细胞比值(NLR)(OR:1.156;95%CI:1.058 - 1.264)和MHR(OR:1.027;95%CI:1.013 - 1.041)是SSII>34.2的独立预测因素。

结论

在预测接受pPCI治疗的STEMI患者冠状动脉疾病严重程度方面,MHR可能是比NLR和C反应蛋白更好的参数。

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