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分析单核细胞/高密度脂蛋白胆固醇比值与早发冠心病患者支架内再狭窄的相关性。

Analysis of the Correlation Between the Ratio of Monocytes to High-Density Lipoprotein Cholesterol and in-Stent Restenosis in Patients with Premature Coronary Heart Disease.

机构信息

191599The First Affiliated Hospital of Zhengzhou University, Zhengzhou City, China.

出版信息

Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221079334. doi: 10.1177/10760296221079334.

Abstract

BACKGROUND

High-density lipoprotein cholesterol (HDL-C) and monocytes are associated with coronary artery disease, and the ratio of monocytes to high-density lipoprotein (MHR) is associated with long-term adverse outcomes and the recurrence of atrial fibrillation. Currently, the trend of coronary heart disease proned to young people is becoming prominent. However, the relationship between MHR and in-stent restenosis (ISR) in patients with premature coronary heart disease (PCHD) has not been investigated. Therefore, we aimed to assess the relationship between MHR and ISR in patients with PCHD.

METHODS

We retrospectively included 257 patients (men ≤ 55 years old, women ≤ 65 years old) with PCHD who underwent drug-eluting stent implantation and follow-up coronary angiography at the First Affiliated Hospital of Zhengzhou University from September 2016 to September 2019. Patients were divided into ISR and non-ISR groups depending on their follow-up coronary angiography results. Relative clinical information was recorded and analyzed. A receiver operating characteristic curve analysis was used to determine the optimum pre-procedural MHR cutoff value to predict ISR.

RESULTS

Logistic regression analysis showed that MHR, smoking history, and fibrinogen were independent risk factors for ISR in patients with PCHD. The area under the receiver operating characteristic curve (AUC) of MHR was 0.750 (95% confidence interval, 0.695-0.820;  < .001), the cutoff value was 546.88, and the specificity and sensitivity were 65.2% and 78%, while the AUC of monocytes was 0.631 (95% confidence interval, 0.638-0.794;  < .001), the cutoff value was 590, and the specificity and sensitivity were 77.1% and 60.0%.

CONCLUSION

MHR is an independent risk factor for ISR in patients with PCHD and showed a certain predictive value.

摘要

背景

高密度脂蛋白胆固醇(HDL-C)和单核细胞与冠状动脉疾病相关,单核细胞与高密度脂蛋白(MHR)的比值与长期不良结局和心房颤动复发相关。目前,冠心病向年轻人发展的趋势越来越明显。然而,早发冠心病(PCHD)患者的 MHR 与支架内再狭窄(ISR)之间的关系尚未得到研究。因此,我们旨在评估 PCHD 患者的 MHR 与 ISR 之间的关系。

方法

我们回顾性纳入了 2016 年 9 月至 2019 年 9 月在郑州大学第一附属医院接受药物洗脱支架植入术并随访冠状动脉造影的 257 例 PCHD 患者(男性≤55 岁,女性≤65 岁)。根据随访冠状动脉造影结果将患者分为 ISR 组和非 ISR 组。记录并分析相关临床信息。采用受试者工作特征曲线分析确定预测 ISR 的最佳术前 MHR 截断值。

结果

Logistic 回归分析显示,MHR、吸烟史和纤维蛋白原是 PCHD 患者 ISR 的独立危险因素。MHR 的受试者工作特征曲线下面积(AUC)为 0.750(95%置信区间,0.695-0.820;<0.001),截断值为 546.88,特异性和敏感性分别为 65.2%和 78%,而单核细胞的 AUC 为 0.631(95%置信区间,0.638-0.794;<0.001),截断值为 590,特异性和敏感性分别为 77.1%和 60.0%。

结论

MHR 是 PCHD 患者 ISR 的独立危险因素,具有一定的预测价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3735/8864282/e1c804f4e8c3/10.1177_10760296221079334-fig1.jpg

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