Relation Between Monocyte To High-density Lipoprotein Cholesterol Ratio With Gensini Score And Adverse Events Of STEMI Patients

Objective:1.To investigate the correlation between Monocyte count to High-density ratio(MHR)and severity of coronary lesion in the patients with coronary heart disease(CHD)and its clinical significance.2.To investigate the relationship of in-hospital mortality and major adverse cardiac events(MACE)with MHR in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention(PCI).Methods:test 1:A total of 302 patients who were admitted to the second hospital of Tianjin medical university with the diagnosis of coronary heart disease and underwent coronary angiography between January 2015 and June 2016 were collected in the first study.All the participants were divided into 2 groups(controllde groups and CHD groupd)by vascular stenosis 50%:And the CHD groups divided into 2 groups(angina groups and AMI group)by the Troponin I,CAG and clinical manifestation.The three groups respectively has 78、132、92 patients.All participants’ vascular were valued by Gensini.At the same time collecting participants’ results of biochemical test and Echocardiography test,like,routine blood,blood lipid level,liver function,kidney function,electrolyte,left ventricular ejection fraction and left ventricular end-diastolic diameter,etc.According to the monocyte cell count and high density lipoprotein levels,calculate MHR.The difference between three groups were compared with the count of monocytes,high density lipoprotein,MHR and Gensini scores.Logist regression analysis was used to analyze the correlation between the levels of Gensini and monocyte,high density lipoprotein,MHR.test 2.A total of 342 patients who were admitted to the second hospital of Tianjin medical university with the diagnosis of acute ST-segment elevation myocardial infarction and underwent primary percutaneous coronary intervention(PCI)April between 2012 and June 2016 were collected in the second study.collecting participants’ results of biochemical test and Echocardiography test,like,routine blood,blood lipid level,liver function,kidney function,electrolyte,left ventricular ejection fraction and left ventricular end-diastolic diameter,etc.According to the monocyte cell count and high density lipoprotein levels,calculate MHR.According to MHR,the participents were grouped into three percentile groups.(MHR<0.26 MHR:0.26-0.42,MHR>0,42),each group has 114 people respectively.in-hospital mortality and major adverse cardiac events(MACE)were statistics and compared.Firstly using Logist single factor regression analyze the correlation between the influencing factors and in-hospital mortality and MACE.Then using multivariate Logist regression analyse analyze the important factors.Result:Test 1.Gensini score and MHR in AMI patients are obviously higher than angina pectoris patients and the angina pectoris patients are higher than contral group.monocyts counts were positively correlated with Gensini score(r=0.30,P<0.05),high density lipoprotein were negative correlated with Gensini score(r=-0.26,P<0.05),MHR were positively correlated with Gensini score(r=0.39,P<0.05).the relativity between MHR and Gensini score are higher than the relativity between monocyts counts and Gensini score.Test 2.12 patients(3.51%)died,and MACE was observed in 78 patients(21.34%)during hospital follow-up,and the in-hospital mortality and major adverse cardiac events(MACE)are obviously higher in tertile 3 than tertile 3(8:1;38:18 P<0.01,P<0.01).In multivariate Logist regression analysis,age,acute heart failure,troponin I,MHR level,independently predicted in-hospital mortality and major adverse cardiac events(MACE).Conclusion: 1.Gensini score are positively correlated with MHR,and the relationship with MHR are higher than the relationship with monocyts counts.2.Admission MHR value were found to be independently correlated with in-hospital mortality and major adverse cardiac events(MACE)after primary PCI who were diagnosed of acute ST-segment elevation myocardial infarction.