Qi MAO, Chaojun XIANG, Yuqing WANG, et al. Effect of ratio of monocyte to high-density lipoprotein cholesterol on prognosis of patients with non-ST-segment elevation acute coronary syndrome[J]. Journal of Third Military Medical University, 2019, 41(5): 454-460.
DOI:
Qi MAO, Chaojun XIANG, Yuqing WANG, et al. Effect of ratio of monocyte to high-density lipoprotein cholesterol on prognosis of patients with non-ST-segment elevation acute coronary syndrome[J]. Journal of Third Military Medical University, 2019, 41(5): 454-460. DOI: 10.16016/j.1000-5404.201810137.
Effect of ratio of monocyte to high-density lipoprotein cholesterol on prognosis of patients with non-ST-segment elevation acute coronary syndrome
摘要
目的
2
探讨单核细胞与高密度脂蛋白胆固醇的比值(monocyte-to-high density lipoprotein cholesterol ratio,MHR)对非ST段抬高型急性冠脉综合征(non-ST-segment elevation acute coronary syndrome,NSTE-ACS)患者预后的影响。
方法
2
本研究为回顾性队列研究,纳入陆军军医大学第二附属医院心内科2017年1月至2017年9月入院的NSTE-ACS患者435例,男性占67.4%,中位年龄62岁。按MHR三分位数将研究人群分为低水平组(0.152~0.433,145例)、中水平组(0.435~0.633,145例)和高水平组(0.636~2.904,145例),比较MHR各组间的临床资料,分析MHR与心血管危险因素的相关性,评估MHR与入院后12个月主要不良心脑血管事件(major adverse cardiovascular and cerebrovascular events,MACCE)的关系。
To investigate the effect of monocyte-to-high density lipoprotein cholesterol ratio (MHR) on the cardiovascular outcomes in the patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS).
Methods
2
This was a retrospective cohort study involving 435 patients diagnosed with NSTE-ACS (males accounted for 67.4% and median age 62 years) who were admitted between January 2017 and September 2017 in our hospital. According to the tertile of MHR
the subjects were divided into the low MHR group (0.152~0.433
n
=145)
the medium MHR group (0.435~0.633
n
=145)
and the high MHR group (0.636~2.904
n
=145). Clinical data were compared among the 3 groups
the correlation between MHR and cardiovascular risk factors was evaluated
and the association of MHR with major adverse cardiovascular and cerebrovascular events (MACCE) was assessed during 12-month follow-up after admission.
Results
2
MHR was positively correlated with C-reactive protein (CRP
r
=0.534
P
<
0.01) and Global Registry of Acute Coronary Event scores (GRACE
r
=0.433
P
<
0.01) in the NSTE-ACS population. During the 12-month follow-up period
totally 78 patients with NSTE-ACS developed MACCE (17.9%)
and their MHR levels were higher than those without MACCE (
P
<
0.01). There were 35
25 and 16 cases respectively developing MACCE in the high
medium and low MHR groups
and significant difference was seen among the 3 groups (
P
=0.006). Kaplan-Meier analysis revealed that the high MHR group had the higher incidence rate of MACCE than the other groups (log-rank=9.786
P
=0.007). COX regression analysis showed that MHR was associated with MACCE (
HR
=2.528
95%
CI
: 1.500~4.261
P
<
0.01). Multivariate analysis further indicated that MHR was an independent predictor of
MACCE after adjustment (adjusted
HR
=2.193
95%
CI
: 1.075~4.472
P
=0.031).
Conclusion
2
MHR is associated with MACCE and is an independent predictor of cardiovascular outcomes in NSTE-ACS patients.
关键词
Keywords
references
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