Monocyte/high-density lipoprotein cholesterol ratio is superior to neutrophil/lymphocyte ratio in the prediction of 3-month overall death in patients with acute ST-elevation myocardial infarction treated with percutaneous coronary intervention

Aim: Although 30-day mortality rates were improved in the setting of acute ST-elevation myocardial infarction (STMI), the same does not hold true for longer-term mortality rates. The ratios of monocyte to high-density lipoprotein cholesterol (MHR) and neutrophil to lymphocyte (NLR) are novel markers with diagnostic and prognostic significance in various disease conditions. Our aim was to evaluate the predictive role of MHR and NLR in in-hospital and 3-month overall death in STMI patients treated with percutaneous coronary intervention (PCI). Material and Methods: A total of 184 consecutive STMI patients undergoing PCI were included. NLR, MHR, clinical and demographic characteristics, and syntax scores were recorded. The patients were divided into two groups according to the median MHR (group 1, n=92; group 2, n=92). In-hospital and 3-month overall death were noted as the primary outcome.Results: Median MHR was 19.31. In-hospital mortality and 3-month mortality occurred in 14 (15.2%) and 21 (22.8%) patients, respectively. NLR and number of the patients with cardiogenic shock on admission were greater in group 2. No mortality occurred in group 1. In multivariate logistic regression analysis, higher low-density lipoprotein cholesterol level, higher syntax score and MHR, but not NLR, were independently associated both with in-hospital and 3-month overall death. In ROC analysis, MHR >36.6 and MHR >46.81 emerged as cut-off values for in-hospital and 3-month mortality, respectively. Conclusion: MHR but not NLR may be utilized in the prediction of in-hospital and 3-month overall death in acute STMI patients treated with primary PCI.