Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
Department of Geriatrics, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
J Cardiothorac Surg. 2023 May 6;18(1):172. doi: 10.1186/s13019-023-02268-4.
Atherosclerosis and thrombosis play important roles in the pathophysiology of acute coronary syndrome, with platelet activation and inflammation as the key and initiative factors. Recently mean platelet volume-to-lymphocyte ratio (MPVLR) and monocyte to high-density lipoprotein cholesterol ratio (MHR) have emerged as new prognostic indicators of cardiovascular diseases. However, the predicting effect of the combination of MPVLR and MHR in myocardial infarction has not been reported.
The aim of this study was to investigate the usefulness of combination of MPVLR and MHR in predicting patients with AMI.
375 patients who had chest pain or stuffiness were retrospectively enrolled in this study. According to the results of coronary angiography and cardiac troponin, patients were divided into AMI group (n = 284) and control group (n = 91). MPVLR, MHR, Gensini score and Grace score were calculated.
MPVLR and MHR were significantly higher in AMI group than that in control group (6.47 (4.70-9.58) VS 4.88 (3.82-6.44), 13.56 (8.44-19.01) VS 9.14 (7.00-10.86), P < 0.001, respectively). Meanwhile, both were positively correlated with Gensini score and Grace score. Patients with a high level of MPVLR or MHR had an increased risk for AMI (odds ratio (OR) = 1.2, 95% confidence interval (CI) 1.1-1.4, OR = 1.2, 95% CI 1.2-1.3). Combination of MPVLR and MHR identified a greater ROC area than its individual parameters (P < 0.001).
Both MPVLR and MHR are independent predictors of AMI. Combination of MPVLR and MHR had higher predicting value in AMI, and thus appears to be a new risk factor and biomarker in the evaluation of risk and severity of atherosclerosis in AMI.
动脉粥样硬化和血栓形成在急性冠状动脉综合征的病理生理学中起着重要作用，血小板激活和炎症是关键和主动因素。最近，平均血小板体积与淋巴细胞比值（MPVLR）和单核细胞与高密度脂蛋白胆固醇比值（MHR）已成为心血管疾病的新的预后指标。然而，MPVLR 和 MHR 联合预测心肌梗死的效果尚未见报道。
本研究旨在探讨 MPVLR 和 MHR 联合在预测急性心肌梗死（AMI）患者中的作用。
回顾性纳入 375 例胸痛或胸闷患者。根据冠状动脉造影和心肌肌钙蛋白结果，将患者分为 AMI 组（n=284）和对照组（n=91）。计算 MPVLR、MHR、Gensini 评分和 Grace 评分。
AMI 组的 MPVLR 和 MHR 明显高于对照组（6.47（4.70-9.58）比 4.88（3.82-6.44），13.56（8.44-19.01）比 9.14（7.00-10.86），P<0.001）。同时，两者均与 Gensini 评分和 Grace 评分呈正相关。MPVLR 或 MHR 水平较高的患者发生 AMI 的风险增加（优势比（OR）=1.2，95%置信区间（CI）1.1-1.4，OR=1.2，95%CI 1.2-1.3）。MPVLR 和 MHR 联合的 ROC 曲线下面积大于其各自参数（P<0.001）。
MPVLR 和 MHR 都是 AMI 的独立预测因子。MPVLR 和 MHR 的联合对 AMI 具有更高的预测价值，因此似乎是评估 AMI 中动脉粥样硬化风险和严重程度的新的危险因素和生物标志物。
