The role of monocyte to HDL ratio in predicting clinically significant carotid stenosis in patients with asymptomatic carotid artery disease

OBJECTIVE: Monocyte count to HDL-C Ratio (MHR) and Fibrinogen to Albumin Ratio (FAR) have recently emerged as markers of inflammation in atherosclerotic diseases. Our goal was to investigate the relationships of MHR and FAR with the severity of carotid artery stenosis (CAS) in patients with asymptomatic carotid artery disease. METHODS: This retrospective study consisted of 300 patients with asymptomatic CAS. Pre-angiographic MHR, FAR, and high-sensitive C-reactive protein (hsCRP) were measured. Carotid angiography was performed in patients with ≥50% stenosis on carotid ultrasonography. Patients were first split into 2 groups based on the degree of CAS and then tertiles (T) of MHR. RESULTS: 96 patients had clinically insignificant CAS (<50%) (Group-1), and 204 patients had clinically significant CAS (≥50%) (Group-2). Group-2 had higher MHR, FAR, and hsCRP than group-1. Patients in T3 had higher MHR, FAR, and hsCRP than in T1 and T2. MHR, FAR, and hsCRP were correlated with each other (p<0.001, for all). MHR, FAR, and hsCRP were independent predictors of significant CAS. MHR better predicted a significant CAS than FAR and hsCRP (p<0.05). CONCLUSION: Pre-angiographic MHR may be a better predictor than FAR and hsCRP in identifying a clinically significant carotid stenosis in patients with asymptomatic CAS. Patients with asymptomatic CAS and a high level of MHR should be followed-up closely to supervise risk-factor control and intensify treatment.