Department of Cardiology, Affiliated Hospital of Beihua University, Jilin City, China.
Department of Gaoxin, China Institute of Standardization, Beijing, China.
Am J Med Sci. 2020 May;359(5):281-286. doi: 10.1016/j.amjms.2020.01.018. Epub 2020 Jan 27.
The monocyte to high-density lipoprotein ratio (MHR) has been used to predict adverse clinical outcomes in patients with acute coronary syndrome (ACS). This meta-analysis aimed to evaluate the prognostic utility of MHR in patients with ACS.
We comprehensively searched for relevant studies in Pubmed, Embase, CNKI, WanFang and VIP databases until March 12, 2019. Epidemiologic studies investigating the association between MHR and major adverse cardiovascular events (MACE) or all-cause mortality in patients with ACS were included. Pooled effect was expressed as risk ratios (RR) with 95% confidence intervals (CI) for the highest versus the reference lower MHR group.
Eight studies involving 6,480 patients with ACS were included and analyzed. Meta-analysis indicated that the highest MHR was significantly associated with higher risk of MACE (RR 1.65; 95%CI 1.36-2.02) and all-cause mortality (RR 2.61; 95%CI 1.29-4.89) after adjusting for the conventional confounders. The prognostic values of MACE with the highest MHR caused no significant changes in the in-hospital follow-up (RR 1.76; 95%CI 1.34-2.32) and >6 months follow-up (RR 1.68; 95%CI 1.08-2.62) subgroups. Furthermore, ST elevation myocardial infarction patients with the highest MHR had a 2.07-fold higher risk of in-hospital MACE (RR 2.07; 95%CI 1.52-2.80).
Elevated MHR is independently associated with an increased risk of MACE and all-cause mortality in patients with ACS. MHR may serve as a potential prognostic indicator for ACS prognosis.
单核细胞/高密度脂蛋白比值（MHR）已被用于预测急性冠脉综合征（ACS）患者的不良临床结局。本荟萃分析旨在评估 MHR 在 ACS 患者中的预后价值。
我们全面检索了 Pubmed、Embase、CNKI、万方和 VIP 数据库中截至 2019 年 3 月 12 日的相关研究。纳入了评估 MHR 与 ACS 患者主要不良心血管事件（MACE）或全因死亡率之间相关性的前瞻性队列研究。汇总效应以最高 MHR 组与参考低 MHR 组的风险比（RR）及 95%置信区间（CI）表示。
纳入了 8 项包含 6480 例 ACS 患者的研究并进行了分析。荟萃分析表明，校正传统混杂因素后，最高 MHR 与更高的 MACE 风险（RR 1.65；95%CI 1.36-2.02）和全因死亡率（RR 2.61；95%CI 1.29-4.89）显著相关。在住院随访（RR 1.76；95%CI 1.34-2.32）和＞6 个月随访（RR 1.68；95%CI 1.08-2.62）亚组中，最高 MHR 导致的 MACE 预后价值无显著变化。此外，最高 MHR 的 ST 段抬高型心肌梗死患者住院期间发生 MACE 的风险增加 2.07 倍（RR 2.07；95%CI 1.52-2.80）。
升高的 MHR 与 ACS 患者的 MACE 和全因死亡率风险增加独立相关。MHR 可能成为 ACS 预后的一个潜在预测指标。
