Key result
Monocyte/HDL ratio strongly predicts severe CAD with ~95% sensitivity.
Why the study?
The monocyte count/HDL-C ratio (MHR) has been studied as a predictor of cardiovascular events in chronic kidney disease, but few studies have examined its role in NST-ACS patients.
Does the monocyte/HDL-C ratio predict coronary artery disease severity in patients with non-ST elevation acute coronary syndrome?
Cohort (n=156)
No
Does the monocyte/HDL-C ratio predict coronary artery disease severity in patients with non-ST elevation acute coronary syndrome?
Effect estimate: AUC 0.975
p-value: p=0.0001
The monocyte/HDL-cholesterol ratio is a strong predictor of coronary artery disease severity, as assessed by the SYNTAX score, in patients presenting with non-ST elevation acute coronary syndrome.
MHR may refine NSTE-ACS severity assessment; leaves open prospective validation before clinical adoption.
Background: Despite the fact that the monocyte count/HDL-C ratio (MHR) has been studied extensively in patients with chronic kidney disease as an independent predictor of both fatal and composite cardiovascular events. Only a few studies have looked at the MHR in patients with non-ST elevation acute coronary syndrome (NST-ACS). Objective: Using the SYNTAX score (SX score) in patients with non-NST-ACS, we will undertake this study to examine MHR as an independent predictor of the complexity and severity of coronary atherosclerosis. Subjects and methods: This study was a cohort analytical retrospective study conducted on 156 patients presented with NST-ACS admitted for coronary angiography, collected from Zagazig Catheterization Laboratory Database. All patients had the following: Cardiac enzymes, complete blood count, lipid profile and serum creatinine. The SX score was determined with baseline coronary angiography Results: Patients were divided into two groups based on their Syntax score: Group 1 (score < 23) and group 2 (Score > 23). There was significant positive correlation between monocyte/HDL-C ratio and SYNTAX score (p=0.001) with correlation coefficient 0.768. Receiver operating characteristic (ROC) curve showed that the best cutoff value for monocyte/HDL-C ratio for prediction of the severity of coronary artery disease assessed by SYNTAX score in the studied population was 22.25 with area under the curve (AUC): 0.975, sensitivity of 95% and specificity of 75%, (p value 0.0001). In-hospital non-fatal MI was higher among patients with high MHR (P: 0.029), but no statistically significant difference between both groups of MHR regarding in-hospital, 3 months CV mortality and 3 months non-fatal MI was revealed. Conclusion: MHR as a novel inflammatory marker is indicated to be an independent predictor of severity of coronary artery disease among patients presenting with NST-ACS.
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Ghanem et al. (2023) conducted a cohort in Non-ST elevation acute coronary syndrome (NST-ACS) (n=156). Monocyte/HDL-Cholesterol Ratio (MHR) was evaluated on Severity of coronary artery disease assessed by SYNTAX score (AUC 0.975, p=0.0001). The monocyte/HDL-cholesterol ratio strongly predicted severe coronary artery disease (SYNTAX score > 23) with an AUC of 0.975 (sensitivity 95%, specificity 75%, p=0.0001).
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