Gong Shu, Gao Ximei, Xu Fubiao, Shang Zhi, Li Shuai, Chen Wenqiang, Yang Jianmin, Li Jifu
The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health.
International Medical Department, Qilu Hospital, Shandong University, Jinan.
Medicine (Baltimore). 2018 Oct;97(43):e12813. doi: 10.1097/MD.0000000000012813.
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 = -0.362, 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 cut-off 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.
本研究旨在通过使用Gensini评分来探讨淋巴细胞与单核细胞比值(LMR)与冠状动脉疾病(CAD)严重程度之间的关系。共有199例行冠状动脉造影的患者纳入本研究并进行回顾性分析。其中,49例冠状动脉正常的患者被选为对照组。CAD患者分为两组,Gensini评分低(≤40)的患者和Gensini评分高(≥40)的患者。我们的结果显示,严重动脉粥样硬化组的LMR显著低于轻度动脉粥样硬化组和对照组。Gensini评分与LMR之间存在密切的显著相关性(r = -0.362,P <.001)。此外,多因素逻辑回归分析表明,LMR(比值比,0.715;95%置信区间[CI],0.551 - 0.927;P =.012)是严重动脉粥样硬化的独立预测因子。使用最佳LMR临界值5.06时,LMR预测严重动脉粥样硬化的敏感性为57.1%,特异性为69.7%(曲线下面积 = 0.634;95% CI,0.545 - 0.724;P =.005)。然后根据LMR值5.06将CAD组患者分为两组。LMR≤5.06的患者预后较差,在长达1年的随访期间心血管事件发生率较高。我们的研究表明,LMR与冠状动脉粥样硬化的严重程度独立且呈正相关,为炎症指标评估CAD严重程度的应用提供了新的见解。并且LMR可能是CAD患者未来心血管事件的有用预测指标。