Wu Chia-Chen, Wu Chia-Hui, Lee Chien-Ho, Chen Tien-Yu, Cheng Cheng-I
Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City 833, Taiwan.
Department of Medical Imaging, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung City 807, Taiwan.
Medicina (Kaunas). 2024 Dec 19;60(12):2084. doi: 10.3390/medicina60122084.
The prognostic value of easily accessible hematologic biomarkers, such as the neutrophil-to-HDL ratio, as well as the monocyte-to-HDL, lymphocyte-to-HDL, and platelet-to-HDL ratios, remains underexplored in patients with established ischemic heart disease (IHD). Community-dwelling adults aged ≥ 20 with established IHD from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 were eligible. Mortality was tracked through linkage to the National Death Index (NDI) until the end of 2019. Cox regressions examined the associations between these hematologic ratios and all-cause mortality. Receiver operating characteristic (ROC) curve analysis assessed the predictive accuracy of these ratios for mortality. A total of 2265 patients were analyzed, with a median follow-up period of 80 months. After adjusting for demographic factors, lifestyle variables, and comorbidities, patients in the highest quartile of the neutrophil/HDL had a significantly increased all-cause mortality risk (aHR = 1.41, 95% CI: 1.13-1.77) compared to those in the lowest quartile. No significant associations were found between the other ratios and mortality. In conclusion, this study found that among the hematologic ratios analyzed, an elevated neutrophil-to-HDL ratio has the strongest potential for mortality risk stratification in community-dwelling patients with ischemic heart disease in the US, offering important guidance for both patients and clinicians.
在已确诊的缺血性心脏病（IHD）患者中，诸如中性粒细胞与高密度脂蛋白比值以及单核细胞与高密度脂蛋白、淋巴细胞与高密度脂蛋白、血小板与高密度脂蛋白比值等易于获取的血液生物标志物的预后价值仍未得到充分研究。来自1999 - 2018年美国国家健康与营养检查调查（NHANES）的年龄≥20岁、患有确诊IHD的社区居住成年人符合条件。通过与国家死亡指数（NDI）联动追踪死亡率直至2019年底。Cox回归分析了这些血液学比值与全因死亡率之间的关联。受试者工作特征（ROC）曲线分析评估了这些比值对死亡率的预测准确性。共分析了2265例患者，中位随访期为80个月。在调整了人口统计学因素、生活方式变量和合并症后，中性粒细胞/高密度脂蛋白处于最高四分位数的患者与最低四分位数的患者相比，全因死亡风险显著增加（调整后风险比[aHR]=1.41，95%置信区间[CI]：1.13 - 1.77）。未发现其他比值与死亡率之间存在显著关联。总之，本研究发现，在美国社区居住的缺血性心脏病患者中，在所分析的血液学比值中，中性粒细胞与高密度脂蛋白比值升高在死亡风险分层方面具有最强的潜力，为患者和临床医生提供了重要指导。
