Key result
A higher lymphocyte-to-monocyte ratio (third vs first tertile) was associated with a lower risk of all-cause mortality in hypertrophic cardiomyopathy patients (HR 0.39; 95% CI 0.17-0.90; p=0.028).
Why the study?
LMR has been proposed as a prognostic factor in cardiovascular diseases, but whether it discriminates HCM patients at higher risk of all-cause mortality was unconfirmed.
Does a higher lymphocyte-to-monocyte ratio (LMR) predict lower all-cause mortality in adult patients with hypertrophic cardiomyopathy?
Cohort (n=354)
Does a higher lymphocyte-to-monocyte ratio (LMR) predict lower all-cause mortality in adult patients with hypertrophic cardiomyopathy?
Hazard Ratio: 0.39 (95% CI 0.17–0.9)
p-value: p=0.028
A higher lymphocyte-to-monocyte ratio is independently associated with a decreased risk of all-cause mortality in adult patients with hypertrophic cardiomyopathy.
LMR may aid HCM risk stratification; hypothesis-generating and requires prospective validation before clinical adoption.
Background The lymphocyte-to-monocyte ratio (LMR) has been proposed as a novel prognostic factor in malignancies and cardiovascular diseases. Our study aimed to ascertain whether LMR is a useful biomarker in discriminating the hypertrophic cardiomyopathy (HCM) patients at higher risk of all-cause mortality. Methods This retrospective study consisted of 354 adult HCM patients. Cox’s proportional hazards regression models were used to analyze the association between LMR and all-cause mortality. Smooth curve fitting was conducted to explore the linear relationship between LMR and all-cause mortality. Results During the follow-up, 44 patients reached the study endpoint. The all-cause mortality rate was 7.3 per 100 person-years in the first tertile and decreased across the three tertiles of LMR. With the first tertile as reference, adjusted hazard ratios (HR) for all-cause mortality were 0.43 for the second tertile (95% CI [0.20–0.91], p = 0.027) and 0.39 for the third tertile (95% CI [0.17–0.90], p = 0.028), respectively. Smooth curve fitting exhibited a nonlinear relationship between LMR values and all-cause mortality. For LMR < 6.5, per SD increase resulted in a significantly decreased risk of all-cause mortality by 62% (HR: 0.38, 95% CI [0.21–0.68]). For LMR ≥ 6.5, the all-cause mortality risk did not progressively increase. Stratified and subgroup analyses revealed similar results to the main analyses,andE-value analysis suggested robustness to unmeasured confounding. Conclusions The study demonstrated that LMR was an independent predictor of all-cause mortality in HCM patients, and LMR may be useful for identifying HCM patients at high mortality risk.
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Chen et al. (2022) conducted a cohort in Hypertrophic cardiomyopathy (n=354). Lymphocyte-to-monocyte ratio (LMR) vs. First tertile of LMR was evaluated on All-cause mortality (HR 0.39, 95% CI 0.17-0.90, p=0.028). A higher lymphocyte-to-monocyte ratio (third vs first tertile) was associated with a lower risk of all-cause mortality in hypertrophic cardiomyopathy patients (HR 0.39; 95% CI 0.17-0.90; p=0.028).
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