不同性别非ST段抬高型急性冠状动脉综合征（NSTE-ACS）患者血清MHR和NLR与冠状动脉病变严重程度的相关性
The correlation between serum MHR and NLR and the severity of coronary lesions in NSTE-ACS patients of different genders.
作者信息
Yang Yanping, Lv Xiaobing, Tan Kai, Li Kai, Li Shaohua, Meng Xia, Chen Yunyun, Wang Fuqing, Xin Hui
机构信息
Department of Emergency, Qingdao West Coast New Area Central Hospital, Qingdao, Shandong, China.
Department of Cardiovascular Medicine, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
出版信息
Front Cardiovasc Med. 2025 Jan 14;11:1469730. doi: 10.3389/fcvm.2024.1469730. eCollection 2024.
BACKGROUND
To study the relationship between the monocyte/high-density lipoprotein cholesterol ratio (MHR) and neutrophil-to-lymphocyte ratio (NLR) and coronary artery stenosis in Non-st-elevation acute coronary syndromes (NSTE-ACS) patients of different genders.
METHODS
A total of 253 control and 800 NSTE-ACS patients were included, and clinic data (29 items) were also collected. NSTE-ACS patients were divided into low-risk (0-23) and high-risk (≥ 23) groups based on the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score. Then, Spearman correlation and multivariate logistic regression analyses were performed to study the associated factors of high-risk SYNTAX score in male and female NSTE-ACS patients, respectively. Finally, the receiver operating characteristic (ROC) curve was used to calculate the diagnostic value of MHR and NLR for predicting high-risk SYNTAX scores in male NSTE-ACS patients.
RESULTS
Sixteen distinct factors differed between the high- and low-risk groups in male NSTE-ACS patients, a significantly higher number than female NSTE-ACS patients. Gout/hyperuricemia, smoking, NLR, and MHR are independent risk factors for arterial stenosis. At the same time, high-density lipoprotein and left ventricular ejection fraction (LVEF) are found to be protective factors in male NSTE-ACS patients. Fibrinogen, apolipoprotein B/A, and neutrophils are identified as independent risk factors for arterial stenosis in female NSTE-ACS patients, while LVEF and high-density lipoprotein are protective factors. Finally, combined NLR and MHR [ = 0.000, 95% confidence interval (CI) = 0.726-0.810] had better predictive efficacy on the degree of arterial vessel stenosis than NLR or MHR alone. The sensitivity and specificity of the ROC curve were 0.672 and 0.769, respectively.
CONCLUSION
The combination of MHR and NLR shows potential for predicting and assessing the severity of coronary artery stenosis in male patients with NSTE-ACS.
背景
研究不同性别非ST段抬高型急性冠状动脉综合征（NSTE-ACS）患者的单核细胞/高密度脂蛋白胆固醇比值（MHR）和中性粒细胞与淋巴细胞比值（NLR）与冠状动脉狭窄之间的关系。
方法
共纳入253名对照者和800名NSTE-ACS患者，并收集临床数据（29项）。根据紫杉醇药物洗脱支架置入术与心脏外科手术协同研究（SYNTAX）评分，将NSTE-ACS患者分为低危（0-23分）和高危（≥23分）组。然后，分别进行Spearman相关性分析和多因素logistic回归分析，以研究男性和女性NSTE-ACS患者高危SYNTAX评分的相关因素。最后，采用受试者工作特征（ROC）曲线计算MHR和NLR对男性NSTE-ACS患者高危SYNTAX评分的诊断价值。
结果
男性NSTE-ACS患者高危组和低危组之间有16个不同因素存在差异，显著多于女性NSTE-ACS患者。痛风/高尿酸血症、吸烟、NLR和MHR是动脉狭窄的独立危险因素。同时，发现高密度脂蛋白和左心室射血分数（LVEF）是男性NSTE-ACS患者的保护因素。纤维蛋白原、载脂蛋白B/A和中性粒细胞被确定为女性NSTE-ACS患者动脉狭窄的独立危险因素，而LVEF和高密度脂蛋白是保护因素。最后，联合NLR和MHR[P=0.000，95%置信区间（CI）=0.726-0.810]对动脉血管狭窄程度的预测效能优于单独的NLR或MHR。ROC曲线的敏感性和特异性分别为0.672和0.769。
结论
MHR和NLR联合应用在预测和评估男性NSTE-ACS患者冠状动脉狭窄严重程度方面具有潜力。
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