Key result
Monocyte-to-HDL ratio variation ≥0 after ACS predicts ~213% higher MACE risk than variation <0.
Why the study?
New tools are needed to identify residual cardiovascular risk after acute coronary syndrome (ACS).
Does a variation in monocyte to high-density lipoprotein cholesterol ratio (ΔMHR) ≥ 0 predict major adverse cardiovascular events in patients after acute coronary syndrome?
Cohort (n=191)
Does a variation in monocyte to high-density lipoprotein cholesterol ratio (ΔMHR) ≥ 0 predict major adverse cardiovascular events in patients after acute coronary syndrome?
Hazard Ratio: 3.13 (95% CI 1.35–7.26)
Absolute Event Rate: 22% vs 7%
p-value: p=0.008
An increase or no change in the monocyte to HDL cholesterol ratio (ΔMHR ≥ 0) between admission and first outpatient visit is an independent predictor of MACE after ACS, suggesting its utility as a marker of residual cardiovascular risk.
ΔMHR ≥0 may flag residual MACE risk after ACS; leaves open prospective validation before clinical adoption.
In clinical practice, we need to develop new tools to identify the residual cardiovascular risk after acute coronary syndrome (ACS). This study aimed to evaluate whether the monocyte to high-density lipoprotein cholesterol ratio (MHR) variation (ΔMHR) obtained during hospital admission (MHR1) and repeated in the first outpatient evaluation (MHR2) is a predictor of major adverse cardiovascular events (MACE) after ACS. One hundred ninety-one patients admitted for ACS were prospectively included. The ΔMHR was calculated by subtracting MHR1 from MHR2. Patients were followed for 166±38 days in which the occurrence of MACE was observed. The best cutoff for ΔMHR was zero (0), and individuals were divided into two groups: ΔMHR<0 (n=113) and ΔMHR≥0 (n=78). The presence of MACE was higher in the ΔMHR≥0 (22%) than in the ΔMHR<0 (7%), with a hazard ratio (HR) of 3.96 (95% confidence interval [CI]: 1.74-8.99; P=0.0004). After adjusting for confounders, ΔMHR≥0 remained an independent MACE predictor with an adjusted HR of 3.13 (95%CI: 1.35-7.26, P=0.008). In conclusion, our study showed that ΔMHR was an independent MACE predictor after ACS. Thus, ΔMHR is a potential marker of residual cardiovascular risk after ACS.
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Figueiredo et al. (2022) conducted a cohort in acute coronary syndrome (n=191). Monocyte to high-density lipoprotein cholesterol ratio variation (ΔMHR) ≥0 vs. ΔMHR <0 was evaluated on major adverse cardiovascular events (MACE) (adjusted HR 3.13, 95% CI 1.35-7.26, p=0.008). A variation in monocyte to HDL cholesterol ratio (ΔMHR) ≥0 after ACS independently predicted a higher risk of MACE compared to ΔMHR <0 (adjusted HR 3.13; 95% CI 1.35-7.26; P=0.008).
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