Sercelik Alper, Besnili Abbas Fikret
Sanko University, School of Medicine, Cardiology Department, Şehitkamil/Gaziantep, Turkey.
Sanko University, School of Medicine, Cardiology Department, Şehitkamil/Gaziantep, Turkey.
Rev Port Cardiol (Engl Ed). 2018 Mar;37(3):217-223. doi: 10.1016/j.repc.2017.06.021. Epub 2018 Mar 31.
The monocyte to high-density lipoprotein cholesterol ratio (MHR) has recently been proposed as a new predictor and prognostic indicator in cardiovascular disease. The TIMI risk score predicts short-term mortality in ST-elevation myocardial infarction (STEMI) patients. However, there have been no studies regarding the association between MHR and TIMI score in patients with STEMI.
A total of 161 patients admitted to our hospital were prospectively enrolled between January 2014 and June 2016. Of these, 111 consecutive patients with a diagnosis of STEMI who underwent primary percutaneous coronary intervention (PCI) were selected as the STEMI group, and the remaining 50 patients, who had angiographically normal coronary arteries, were selected as the control group. The 111 STEMI patients were then divided into two subgroups based on TIMI scores.
MHR was significantly higher in the STEMI group than in the control group (1.71±0.47 vs. 2.21±0.98, p=0.001) and was significantly higher in the high TIMI score group than in the low TIMI score group (1.80±0.59 vs. 2.42±1.09, p=0.001). In multivariate logistic regression analysis, MHR was the only independent predictor of acute STEMI and high TIMI score. In correlation analysis, there was a significant positive correlation between MHR and TIMI score in STEMI patients (r=0.479, p<0.001). The cutoff value of MHR for high TIMI score in patients with STEMI was 2.409, with a sensitivity of 43.06% and a specificity of 87.18% (AUC 0.669; 95% CI 0.569-0.8769; p=0.003) on ROC curve analysis.
This study indicates that MHR is independently and significantly associated with TIMI score in patients with STEMI. MHR is a novel inflammation-based marker and may be an independent predictor of future cardiovascular events in patients with STEMI.
单核细胞与高密度脂蛋白胆固醇比值（MHR）最近被提议作为心血管疾病的一种新的预测指标和预后指标。TIMI风险评分可预测ST段抬高型心肌梗死（STEMI）患者的短期死亡率。然而，目前尚无关于STEMI患者中MHR与TIMI评分之间关联的研究。
2014年1月至2016年6月期间，前瞻性纳入我院收治的161例患者。其中，连续111例诊断为STEMI并接受直接经皮冠状动脉介入治疗（PCI）的患者被选为STEMI组，其余50例冠状动脉造影正常的患者被选为对照组。然后，将111例STEMI患者根据TIMI评分分为两个亚组。
STEMI组的MHR显著高于对照组（1.71±0.47对2.21±0.98，p=0.001），高TIMI评分组的MHR显著高于低TIMI评分组（1.80±0.59对2.42±1.09，p=0.001）。在多因素逻辑回归分析中，MHR是急性STEMI和高TIMI评分的唯一独立预测因子。在相关性分析中，STEMI患者的MHR与TIMI评分之间存在显著正相关（r=0.479，p<0.001）。STEMI患者高TIMI评分的MHR截断值为2.409，在ROC曲线分析中，敏感性为43.06%，特异性为87.18%（AUC 0.669；95%CI 0.569 - 0.8769；p=0.003）。
本研究表明，STEMI患者的MHR与TIMI评分独立且显著相关。MHR是一种基于炎症的新型标志物，可能是STEMI患者未来心血管事件的独立预测因子。
