The value of the monocyte to high-density lipoprotein cholesterol ratio in predicting the thrombosis burden and long-term prognosis of acute myocardial infarction patients: a retrospective cohort study

초록

Background: Percutaneous coronary intervention has an irreplaceable role in the treatment of patients with acute myocardial infarction (AMI), but it may exacerbate distal microthrombosis, lead to the further impairment of myocardial perfusion and microcirculation, and ultimately lead to a poor prognosis. Therefore, it is important to evaluate biomarkers that help estimate the thrombosis burden and longterm prognosis of AMI patients. Recent studies have found that the monocyte-to-high-density lipoprotein cholesterol ratio (MHR) is closely related to the development of cardiovascular disease. The present study aimed to investigate the value of the MHR in predicting the thrombosis burden and long-term prognosis of AMI patients. Methods: From January 2018 to December 2019, the data of 324 AMI patients who underwent percutaneous coronary intervention at Affiliated Jinhua Hospital, Zhejiang University School of Medicine were retrospectively collected. All the patients underwent percutaneous coronary intervention. The thrombosis burden of the patients was assessed by thrombolysis in myocardial infarction (TIMI) grading. The MHR of the patients on admission was detected by automatic blood routine analyzer and automatic biochemical analyzer, and the MHR was calculated. According to the median of MHR, the patients were assigned to the high MHR group (n=162), and low MHR group (n=162). The patients were followed for 5 years. The incidences of recurrent major adverse cardiovascular events (MACEs) and mortality were observed, and the relationships between the MHR, and the thrombosis burden, MACE, and mortality were analyzed. Results: Significant differences were found in the left ventricular ejection fraction (LVEF), TIMI grade, the rate of 5-year MACE, and 5-year mortality between the high and low MHR groups (P<0.05). The MHR was valuable in predicting grade 4-5 TIMI, 5-year MACE, and 5-year mortality in the AMI patients, which had areas under the curve of the receiver operating characteristic (ROC) curves of 0.776 [95% confidence interval (CI): 0.712-0.840, P<0.001], 0.743 (95% CI: 0.681-0.805, P<0.001), and 0.790 (95% CI: 0.726-0.854, P<0.001), respectively. A high MHR was an independent risk factor for grade 4-5 TIMI, the 5-year MACE rate, and 5-year mortality in AMI patients, which had relative risks of 2.367 (95% CI: 1.165-4.807), 2.259 (95% CI: 1.088-4.690), and 2.524 (95% CI: 1.214-5.245). Conclusions: The MHR can be used to predict the thrombosis burden and long-term prognosis of AMI patients.

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