Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.
Front Immunol. 2023 Jun 22;14:1120245. doi: 10.3389/fimmu.2023.1120245. eCollection 2023.
The implication of the monocyte-to-high-density lipoprotein ratio (MHR) in Takayasu arteritis (TAK) remains unclear.
We aimed to assess the predictive value of the MHR to identify coronary involvement with TAK and determine the patient prognosis.
In this retrospective study, 1,184 consecutive patients with TAK were collected and assessed, and those who were initially treated and with coronary angiography were enrolled and classified according to coronary involvement or no involvement. Binary logistic analysis was performed to assess coronary involvement risk factors. Receiver-operating characteristic analysis was used to determine the MHR value to predict coronary involvement in TAK. Major adverse cardiovascular events (MACEs) were recorded in patients with TAK and coronary involvement within a 1-year follow-up, and Kaplan-Meier survival curve analysis was conducted to compare MACEs between them stratified by the MHR.
A total of 115 patients with TAK were included in this study, and 41 of them had coronary involvement. A higher MHR was found for TAK with coronary involvement than for TAK without coronary involvement ( = 0.014). Multivariate analysis showed that the MHR is an independent risk factor for coronary involvement in TAK (odds ratio: 92.718, 95% confidence interval (): 2.813-3056.291, 0.011). With the best cut-off value of 0.35, the MHR identified coronary involvement with 53.7% sensitivity and 68.9% specificity [area under the curve (AUC): 0.639, 95% : 0.544-0.726, 0.010] and identified left main disease and/or three-vessel disease (LMD/3VD) with 70.6% sensitivity and 66.3% specificity (AUC: 0.704, 95% : 0.612-0.786, 0.003) in TAK. Combined with other variables, the MHR identified coronary involvement with 63.4% sensitivity and 90.5% specificity (AUC: 0.852, 95% : 0.773-0.911, < 0.001), and identified LMD/3VD with 82.4% sensitivity and 78.6% specificity (AUC: 0.827, 95% : 0.720-0.934, < 0.001) in TAK. A total of 39 patients with TAK and coronary involvement were followed up for 1 year, and 5 patients suffered a MACE. Those with an MHR >0.35 had a higher MACE incidence than their counterparts with an MHR ≤0.35 (χ=4.757, = 0.029).
The MHR could be a simple, practical biomarker for identifying coronary involvement and LMD/3VD in TAK and predicting a long-term prognosis.
单核细胞-高密度脂蛋白比值（MHR）在大动脉炎（TAK）中的意义尚不清楚。
评估 MHR 识别 TAK 患者冠状动脉受累的预测价值，并确定患者预后。
本回顾性研究共纳入 1184 例连续的 TAK 患者，对初始治疗且有冠状动脉造影的患者进行评估，并根据冠状动脉受累与否进行分类。采用二元逻辑分析评估冠状动脉受累的危险因素。采用受试者工作特征（ROC）曲线分析确定 MHR 值预测 TAK 患者冠状动脉受累的价值。记录 TAK 患者冠状动脉受累后 1 年的主要不良心血管事件（MACE），并采用 Kaplan-Meier 生存曲线分析按 MHR 分层比较 MACE 发生率。
本研究共纳入 115 例 TAK 患者，其中 41 例有冠状动脉受累。与无冠状动脉受累的 TAK 相比，有冠状动脉受累的 TAK 患者 MHR 更高（ = 0.014）。多因素分析显示，MHR 是 TAK 患者冠状动脉受累的独立危险因素（比值比：92.718，95%置信区间：2.813-3056.291， 0.011）。MHR 的最佳截断值为 0.35，其识别冠状动脉受累的敏感性为 53.7%，特异性为 68.9%[曲线下面积（AUC）：0.639，95%：0.544-0.726， 0.010]，识别左主干病变和/或三血管病变（LMD/3VD）的敏感性为 70.6%，特异性为 66.3%（AUC：0.704，95%：0.612-0.786， 0.003）。与其他变量联合时，MHR 识别冠状动脉受累的敏感性为 63.4%，特异性为 90.5%（AUC：0.852，95%：0.773-0.911， ＜0.001），识别 LMD/3VD 的敏感性为 82.4%，特异性为 78.6%（AUC：0.827，95%：0.720-0.934， ＜0.001）。共 39 例 TAK 合并冠状动脉受累患者随访 1 年，发生 MACE 5 例。MHR＞0.35 的患者 MACE 发生率高于 MHR≤0.35 的患者（χ=4.757， = 0.029）。
MHR 可作为一种简单实用的生物标志物，用于识别 TAK 患者的冠状动脉受累、左主干病变和三血管病变，并预测长期预后。
